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1 NURSING Section 002 PROFESSIONAL GROWTH II - THE NURSING PROFESSION Don't go through life, grow through life. Eric Butterworth COURSE SYLLABUS January Instructor: Louise Le Cavalier, RN, BSN, MN

2 Week Date Topics Class Schedule and Content 1 Jan 11 Introduction, overview of course content, criteria for evaluation WebCT Introduction to Teaching and Learning 2 Jan 18 Theoretical Perspectives in Teaching/Learning 3 Jan 25 Determinants of Learning Learner Motivation and Compliance Health Behaviors 4 No WebCT Feb 1 Literacy in the Adult Population Teaching Plan: Submit 1) group members names; 2) CNA specialty nursing certification; 3) topic (special knowledge/skill) for teaching and 4) a one page outline 5 Feb 8 Quiz #1 (20%) 1 hour Gender, Socioeconomics, and Culture 6 Feb 15 Writing Behavioral Objectives & Teaching Plans Instructional Methods Instructional Materials Evaluation of teaching/learning 7 No WebCT Feb 22 Spring Break No scheduled classes 8 March 1 Standards for Nursing Practice No Health Professions Act WebCT 9 March 8 Quiz #2 (20%) 1 hour Legal and Ethical Issues in Nursing Violence & Abuse Nurses in the workplace 10 March 15 Politics, Power, and Policy Introduction to Quality Improvement 11 March 22 Life Long Learning Certification; Competency; Credentialing Teaching Plan and CNA Certification paper work due 12 March 29 Group Presentations 13 April 5 Caring for Self and Each Other as Nurses; Power Structures; and Empowerment Self-Evaluation (Professional Accountability) due 2

3 Instructor Contact Information: N SECTION 001 Day Thursday Time hrs Room B029 Instructor Louise Le Cavalier, RN, BSN, MN Office L 008 Telephone Office Cell Home llecavalier@langara.bc.ca Course Description This course builds on the philosophy and concepts that were examined in Professional Growth 1, and it further explores the professional practice of nursing. Emphasis is placed on the roles and responsibilities, knowledge and skills of nurses as educators and advocates, the standards for professional practice, and some issues and trends that affect the nursing profession. Ends-In-View This course provides opportunities for participants to begin to explore and examine their role as health educators and health counselors with individuals, families and groups in a variety of contexts. Participants explore nursing as a profession, including professional rights and responsibilities of nurses, and their legal and ethical obligations. The course promotes participants understanding of the purpose and function of professional nursing associations and organizations, particularly in relation to the maintenance and improvement of standards of the nursing profession. Process Weekly classes are 4 hours in length, two hours in a face-to-face environment and two hours in a virtual environment using WebCT as a platform. Classes will consist of lecture active participation, sharing of 3

4 clinical practice experiences, individual work, and small and large group work. There may also be guest speakers for some of the classes. Based on previous learning, experiences incorporate concepts from all courses in this semester. Participants actively engage in professional and health education activities for individuals, families and groups. These activities encourage participants to reflect on their personal meanings and ways of being as professional, teacher, and learner. Learning activities provide participants with opportunities to examine the nursing profession and the inherent rights and responsibilities of its members. Preparation for class involves completing required readings, visiting various websites and completing assigned homework when required (for each hour of class/webct, students are encouraged to spend 2-3 hours of preparation). Students should prepare adequately to ensure optimal learning. Resources include: Canadian Nurses Association College of Registered Nurses of British Columbia British Columbia Nurses Union International Council of Nurses Canadian Health Network Guest speakers; video presentations; selected readings Students are invited to visit other health related websites and to share pertinent information with instructor and classmates. Required Textbooks: 4 McIntyre, M. & Thomlinson, E. (2006). Realities of Canadian nursing: Professional, practice, and power issues (2 nd ed.). Philadelphia: Lippincott, Williams & Wilkins.

5 Overview Bastable, S. (2003). Nurse as educator: Principles of teaching and learning for nursing practice (2 nd ed.). Jones and Bartlett Publishers. American Psychological Association (2001). Publication manual of the American Psychological Association (5 th ed.). Washington, DC: Author. This course is organized around the philosophical foundations of the curriculum and reflects the following concepts: Teaching and learning of individuals and families across the life span; theoretical perspectives of teaching and learning Determinants of learning; motivation and compliance; health behaviours Gender, socioeconomic and cultural issues affecting learning; adult literacy Development of teaching plans; teaching/learning methods and strategies Evaluation of teaching/learning Nursing organizations and professional associations Professionalism: Code of Ethics; Health Professions Act; legal statutes governing nursing practice; standards of practice; legal and ethical aspects of the nursing profession Workplace violence, abuse, and vulnerability in caregiving roles in the workplace Politics, power and policy making Education: life-long learning; credentialing; continuing competence; certification; professional development. Continuous quality improvement and quality assurance; accreditation Collective bargaining; quality of work life; workplace issues i.e. safety; nurses voice Caring for self and others in the nursing profession; empowerment in the nursing profession. 5

6 Evaluation Criteria Value Teaching Plan/CNA Nursing Certification Project 20 % Quiz # 1 20 % Quiz # 2 20 % Final Exam 20 % WebCT 15 % Professional Responsibility and Accountability 5 % Total 100 % Final Exam to be scheduled during exam period Quizzes and Final Exam (20 marks X3= 60 marks) The two quizzes will be based on course content covered up to the day of each quiz. The final exam will be based on material covered after the last quiz and up to the day of the final exam. The quizzes and the final exam will cover WebCT content, as well as all required readings, handouts and other course resources. The Teaching Plan/Nursing Certification Project (20 marks) You will work in groups of 4 to develop and implement a teaching plan to educate nurses entering into a specialty practice area that requires certification with the CNA. You will teach about a specific topic and/or related skill(s) that are required for practice in that particular specialty area of nursing. Please note that this must be an area for which certification exists in Canada thru CNA, and not thru BC or other province. You will research a specific certification program. Refer to the CNA web site for information concerning certification. Click on the link Obtaining CNA certification 7_e.pdf to obtain information about the various certification programs available to nurses in Canada, and review the various certification for Nursing Specialties (Competencies) and their respective links for additional information. CNA offers certification in 17 nursing specialties. The national nursing specialty associations are actively involved in, and endorse, the CNA Certification Program. You will use your course textbooks, CNA website and other links provided, peerreviewed journal articles, other health related websites, and other relevant sources of information to complete this project. 6

7 Submission of Written Work: You must submit written work to the instructor as per course schedule: 1) A detailed teaching plan hard copy, maximum 2 pages (refer to format in Bastable text on page 342). 2) A paper consisting of detailed information that fully describes the selected certification program and the content that you will teach, with all of the references utilized to research your selected topic and nursing certification program. Use APA formatting and guidelines. Requirement 5-6 double spaced pages. Your group will develop and implement the teaching plan and TEACH classmates. Each group member will receive the same mark. It is important that you divide the work evenly amongst the group as much as possible, and that each group member fulfill his/her responsibilities to the group. The following steps are involved in this assignment: 1. Form your group. Groups should consist of no more that 4 members. 2. Choose the specialty area of nursing practice that your group wishes to learn about. Please note that this must be an area for which certification exists in Canada. Refer to the CNA web site for information concerning certification. Follow the certification program's link to view the certification exam list of competencies which will give you concrete information regarding what is expected level of knowledge and skills for each nursing specialty. For example, if I follow the Hospice Palliative Care certification exam list of competencies, I see that one of the expectations is that these nurses are able to anticipate, recognize and respond to the S & S of common emergencies and incidents such as hemorrhage (see on page 7). The knowledge and skills relating to this competency are specific and amenable to teaching... Define the practice specialty, using current terminology. For example, what is its history? What types of clients and 7

8 locations of practice area are typical for this practice area? What formal education programs exist in Canada? What is the typical career path of nurses in this nursing practice specialty? Is interdisciplinary team work characteristic of the work conducted by nurses? How so? Why would a nurse choose to work in his specialty area of practice? Provide examples of knowledge and skills required in this specialty. How is delivery of nursing care typically organized? What are current trends and issues pertaining to this specialty? What might be some of the benefits/risks for nurses working in this specialty? Explain. So, for example, if a group has chosen to investigate the work of nurses in the Hospice Palliative Care certification, it can go to the Canadian Hospice Palliative Care Association website (link is provided on CAN website) and look for history of nursing in this specialty: 3. By February 1 st, submit to this instructor: 1) Your group members names; 2) CNA nursing certification program; 3) Topic (knowledge/skill) for teaching 4) A one page outline 4. Determine the special knowledge and skills that a nurse requires to work in this area of practice. This will involve research about the area of practice and might also involve interviewing someone currently working in that area of practice. 5. Decide what your group will teach. Choosing only one topic to teach will help you to focus your plan. Clearly explain why this skill or knowledge is necessary to practice in the specialty area. 6. Develop a teaching plan. Use the information in the Nurse as Educator textbook to help you with this part of the assignment (in particular, refer to chapters 4, 10, 11, 12, 14 and 15). 7. Organize your written teaching plan according to the table on page 342 of the text. Provide all necessary details. 8

9 8. Teach!!! The time limit for the teaching session is 15 minutes including setting up. Teaching Plan breakdown of marks (20 marks): Presentation (5 marks): Was outline provided? Was feedback solicited from instructor? (1mark); Was the content clearly presented? (2 marks); Was the presentation interesting? (1 mark); Did the group stay within 15 minutes time allotment? (1 mark) Written Work (15 marks): PAPER: Is the specialty practice area that requires certification in Canada clearly defined and described in the paper? Is the importance of the special knowledge and skills that a nurse requires to work in this area of practice clearly explained? (3 marks); TEACHING PLAN: Is purpose of teaching plan clearly identified? (this includes why nurses in this area require the skill or knowledge that your plan addresses (1 mark); Are learning goal(s) well defined? (1 mark); Are behavioral objectives well defined? (3 marks); These will identify learner activities. Make sure each objective addresses all the correct components of the teaching plan identified (see examples on page 342 in your text). Does teaching plan include well organized content outline? (2 marks); Are method(s) of instruction well defined? (2 marks); Be sure to include a rationale for why each strategy was chosen, using Kolb s learning styles (on pp of your text). Were pertinent resources used effectively? (1 mark); 9

10 Was method of evaluation relevant and useful? (1 mark); Was a comprehensive reference list included? (1 mark); 10

11 Group #: Teaching Plan Evaluation Criteria Instructor s Comments Marks Presentation: (5marks) Was outline provided? Was feedback solicited from instructor? Was the content clearly presented? /2 Was the presentation interesting? /1 Did the group stay within 15 minutes time allotment? Subtotal: /5 Written Work: (15 marks) Is the specialty practice area that requires certification in Canada clearly defined and described? Is purpose of teaching plan clearly identified? Are learning goal(s) well defined? /1 Are behavioral objectives well defined? /3 Does teaching plan include well organized content outline? Are method(s) of instruction well defined? Were pertinent resources used effectively? 11 /1 /1 /3 /1 /2 /2 /1 Was method of evaluation relevant and useful? /1 Was a detailed reference list included? /1 Subtotal: /15 Total Mark: /20

12 Group Participants Group A Jennie Victoria Tracey Rosie Group B Group C Group D Group E Group F Group Presentations Teaching Plan/CNA Certification Specialty Area of Nursing Practice/Certification Emergency Nursing 12 Specific Topic of Interest (to be taught) Group G

13 Students who require additional information and/or clarification regarding the Teaching Plan/Nursing Certification project should contact the instructor as soon as possible. WebCT Process and Guidelines (15 marks) WebCT discussions are an integral part of Professional Growth II and worth 15% of the total course grade. The discussions are intended to be an extension or supplement to in-class content. A wide range of topics of interest to the nursing profession will be presented for discussions thorough learning activities. The primary objectives of WebCT discussions are to: Encourage students to further explore and learn about a number of topics concerning the profession of nursing, hence contributing to their professional growth; Stimulate critical thinking; Promote healthy discussion and debate amongst participants; Foster effective group dynamics and processes; Encourage students to become more comfortable in expressing their ideas, personal thoughts, opinions and impressions in an assertive and yet sensitive manner; Help students discover that there are many different and legitimate perspectives to any single issue or topic of interest; Help students to experience feeling valued for their input Today s health professionals are frequently engaged in group work as they share their knowledge and interact with colleagues, individuals and their families, groups, communities and others. WebCT activities are meant to provide opportunities for students to practice these skills and to learn from each other. Guidelines: The instructor will randomly assign members to different groups. Only members of any given group will have access to the group s conversations. The instructor will post a message with the names of participants in each group at the beginning of the term. During Week 1, each participant will post a message of introduction, when each student will tell the group about themselves in a brief summary. 13

14 Each week, and after class (by Friday at 1200 hrs.), the instructor will post a NEW topic of discussion. Following the instructor s posting, students will then have an opportunity to respond to each other s comments during the following 10 days. Anyone in the group may begin a discussion by posting comments to the group. Others will respond as they review each others postings and contribute to the discussion. Each student will be required to post a MINIMUM of TWO wellthought through responses (postings) for each discussion topic, taking into consideration the topic at hand and other group members input. Students who fail to post at least twice will receive zero for that week. Take time to read each other s comments carefully and to REFLECT before composing a response which illustrates evidence of learning, and personal and professional growth. Quality of content versus quantity of postings is critical for success in WebCT please refer to evaluation criteria for CONTENT AND REFLECTION. Join the discussions within the scheduled time frame each week. Last minute postings and rewrites which fail to make any valuable contribution to the discussion will not be considered for marking. Posting #1 should be made within the first five days of the posted topic. Make every effort to post pertinent and relevant comments, thought-provoking questions and meaningful responses. Please be as concise and succinct as possible in the interest of time, which is a rare commodity in Term IV. Discussions should not go on any longer than approximately 10 days on any given topic so that students may proceed through the course in a timely manner. Group members may negotiate time frames for posting in WebCT. For example, a group s members may agree that postings will be generated at regular intervals on Monday, Wednesday and Friday evenings and Sunday mornings. By midterm, a student may request to be moved to another WebCT discussion group, if s/he has experienced particular 14

15 difficulties working within the assigned group. If possible, the instructor will make these arrangements. Students who are unable to participate in WebCT discussions for illness and/or other legitimate reasons will notify the instructor and his/her assigned group via WebCT in a timely manner. There are ten days to post each week students are expected to contribute unless it is absolutely impossible to do so. Marks will be deducted unless the instructor has exempted the student from participation. Each student will receive a mark based on the extent of 1) individual participation and collaboration within the group; 2) adherence to WebCT guidelines; and 3) ability to meet evaluation criteria for Content and Reflection, and Conduct. It is worthwhile to remember that marks are very rapidly deducted when students choose not to post. It is to each student s advantage to post every week when it is required. In your course schedule, I have indicated dates when there will be no WebCT, as per our agreement in class. Please remember the following tips: Be respectful of everyone s contributions Invest time and effort into participating to make it interesting for the entire group Be willing to respectfully challenge another s ideas and opinions and to be challenged in the same manner While students are encouraged to use good grammar, punctuation and spelling as much as possible, marks will not be deducted for errors made. It is important for students to express their ideas and opinions openly and effectively rather than to worry about proper writing style and formatting. Follow Web Netiquette guidelines and do be conscious of acceptable conduct. Here are a few links to websites that offer advice regarding Netiquette: te.htm 15

16 Support: The instructor will 1) be a member of each group; 2) provide input and/or feedback, guidance, direction and encouragement as necessary; 3) monitor each group s activities on a regular basis; and 4) post important messages, as required. Students who experience difficulty with WebCT discussions will request assistance from the instructor and/or other group members as necessary. A student who is not performing adequately in WebCT discussions will be notified early by the instructor in order that he/she may have an opportunity to improve in remainder of the course. Feedback will be provided by mid-term as requested by each student. Note: Slackers may be challenged by members of a group as necessary. These members will do so with diplomacy and care, honoring principles of team building, problem solving and conflict resolution. Evaluation Criteria Use of guidelines Content Indicators WebCT guidelines are followed Writing demonstrates adequate knowledge and comprehension of subject matter - EVIDENCE OF LEARNING Clear, logical thinking, and application of learning are evident Development, description, comparison, and explanation of content are evident Postings incorporate information/knowledge from the literature, required course readings, lectures, class discussions, and other reliable sources Topics of discussions are supported by examples from personal and professional experience 16 Conduct Point of view/voice of author is respectful, consistent and appropriate Web netiquette is followed Positive and constructive criticism are provided and received\ Reflection Reflection on personal and professional growth and learning are evident

17 Student Professional Responsibilities As per the Calendar , College and Student Responsibilities, students must attend all classes, lectures, laboratories, workshops and seminars. Irregular attendance may result in the exclusion of students from classes. Absence for any cause in no way relieves students of the responsibility for completing the work of the course to the satisfaction of the instructor. If students are unavoidably absent because of illness or some other acceptable cause, they are still responsible for class work or assignments missed. If repeated absences are due to illness, students may be asked to submit a medical certificate. If students are absent during the semester from any examination for which due notice has been given, they may be required by the instructor to report to the Dean of Student Support Services upon their return to the College. 1. Class Attendance: Each student is responsible for signing the attendance sheet. Attendance will not be marked by the instructor. However, please refer to Professional Responsibility and Accountability self-assigned marks. 2. Absenteeism: Students who are ill and/or unable to attend class and/or write exams for other legitimate reason MUST contact this instructor by PRIOR to the scheduled class. It is essential that students take full responsibility for making up for missed content. This instructor will not be responsible for reteaching the class material that has been missed. Students should make arrangements for another student to obtain class hand-outs, etc. on their behalf. When students return to class, they should approach the instructor to discuss theoretical content and strategies for making up lost time, as necessary. 3. Missed Exams: In cases of illness and/or other serious and legitimate reasons, the instructor will determine an alternate date and time for writing of an exam, as long as the conditions described above have been met to the instructor s satisfaction. In all other cases, students will receive a mark of ZERO. 4. Punctuality: As a professional courtesy to others and to maximize classroom learning, please be punctual. Each student is responsible for organizing in such a way that he/she arrives on time at the start of each class as well as following breaks. Classes are scheduled at on Thursdays. Times for breaks will be negotiated between instructor and students during class. If you are going to be late, please do not disrupt the class when you arrive to class. 5. Preparedness: This is essential to your success in this course. For the classes to be conducted in an effective manner, each student must prepare adequately. 17

18 Please ensure that you have completed all required readings and other learning activities listed in the In preparation portion of each class. 6. Participation: During class, each student is expected to actively participate. Please ask questions (there are no stupid or inappropriate questions in any healthy learning environment ) and seek clarification as necessary. Please share your personal and professional thoughts, ideas and experiences with others to contribute to a rich learning environment. 7. Professionalism: You will build on your professionalism and interpersonal skills in this class. Providing feedback and challenging others statements, ideas and/or opinions must be done with sensitivity and respect for others, and with the intent to promote further learning and cooperation in class. Inappropriate language, behaviour and/or conduct towards this instructor and/or other students will not be tolerated. In such cases, a student may be asked by the instructor to leave class in order for others to enjoy a more positive learning environment. Professional Responsibility & Accountability (5 self-assigned marks) Students will assign themselves a mark out of 5 and will provide to the instructor a summary (one double spaced page) of their self-evaluation to justify their mark. This mark is based on professional responsibility/accountability in this course; class attendance; obtaining material/handouts when class missed preparedness for class; contribution and participation in class work and discussions contribution and participation WebCT; the ability to work in collaborative partnerships and groups; professional conduct demonstrating respect to others in the classroom If the mark should appear grossly underestimated or overestimated by the student, the instructor may reserve the right to challenge this mark. 18

19 Concept: Introduction to Teaching and Learning OVERVIEW The Collaborative Nursing Program (CNP) curriculum is defined as the interactions that take place between and among students, clients, practitioners, and faculty with the intent that learning takes place. To this end, the curriculum is based on Bevis and Watson s (1989) conceptualization of a caring curriculum of nursing. That view of curriculum places major emphasis on the quality of relationships in an education program, rather than on the course of studies, behavioural objectives, threads, or themes that many nursing education programs stress. The relationships students have with others are varied, such as those with clients, the practitioners they work with, their peers, and their teachers. Teachers are seen as expert learners working with students in partnership in empowering ways, drawing on student experience and on theory of various kinds to develop the content to be learned. Students, practitioners, faculty, and clients are equally valued as partners in the learning process in the Collaborative Curriculum. Learning is a reformulation of the meaning of experiences and leads to changes in attitudes, feelings, and responses. Learning is critically affected by the learner s concept of self, which is itself learned. The self concept is enhanced when learners have a need to know, when they perceive learning as relevant and meaningful, and when they believe they have a chance of success. It is further enhanced when the learner s past and present experiences are acknowledged, respected, and reflected upon. When learners share the responsibility for identifying their learning needs, and planning and evaluating their learning experiences, their self-confidence increases and they become increasingly self-directed. Learners learn best when they feel cared for and challenged, and when they experience success. (Collaborative Nursing Program in British Columbia. Collaborative curriculum guide, Sept. 2002). ENDS-IN-VIEW Establish ground-rules that will allow you to create an environment conducive to teaching and learning Investigate the concepts of teacher and learner Identify the purpose, benefits, and goals of patient and staff education 19

20 Compare and contrast the education process to the nursing process Understand why patient and staff education are important functions for nurses Identify barriers to education and obstacles to learning Explore your own personal philosophy of teaching and learning Review selected ethical principles and acts regulating nursing practice, and implications for nursing practice and education IN PREPARATION Reflect on environmental factors that you find most conducive to learning and be prepared to establish group ground rules to facilitate your learning. Reflect on your past experiences with teaching and learning to identify barriers as well as the purpose, benefits, and goals of education. Review: Collaborative Nursing Program of British Columbia (2002, March). Collaborative curriculum guide (Revised). Victoria: Author. Required Reading: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 1. WebCT Discuss in your groups the elements that you feel are important to the establishment of a positive environment for learning. Some of the issues that you may wish to consider may include: In what type of environment do I learn best? What helps me to feel comfortable to share my ideas and opinions? How may I help others to share their ideas and opinions? What things distract me from learning? How can I do to make this classroom experience a positive one? What do I need from my peers? From my instructor? Each group will then recommend and submit one golden ground rule for our community of learning in N2121 section 002 class. The instructor will then develop a document that will consist of the seven golden ground rules for our class to use during the term. 20

21 REFLECTION Reflect on the following in this coming week: What role do we each play in creating an environment for learning? Can we learn in isolation or is a community of learning essential for learning to occur? How do the concepts discussed in WebCT inform your practice as a nurse-teacher? Are there rules about successful teaching and learning? How does the concept of caring relate to teaching and learning? What do you believe about what is needed to learn or how people learn? How can we overcome barriers and obstacles to education and learning? We will discuss your views and opinions at the beginning of next week s class. Come prepared to contribute to our understanding of our beliefs and values and how these influence our ability to learn and to educate others. Each student will also consider a past personal experience involving their own learning. Jot down some brief notes that will help explain the following and be prepared to share this experience with other students in class next week. Identify significant people and events involved. What in this experience stands out for you either in a positive or negative way? Identify your thoughts, feelings and actions at the time. What did the other involved individuals do that facilitated your learning? What did the other involved individuals do that hindered your learning? What most valuable lesson(s) did you learn from this experience? How has this experience shaped you as a learner? How has it prepared you as a nurse educator? 21

22 Concept: Theoretical Perspectives of Learning OVERVIEW A major focus of this course is that you learn to assess the specific learning needs of an individual and family in a specific context, set ends-in-view for learning, plan and implement specific teachinglearning strategies and evaluate the effectiveness of your session. Before you begin this process, it is important to have an understanding of the various theories and philosophies of learning and how they influence the learning process. Critical thinking skills are an essential prerequisite to both examining the philosophical perspectives and to carrying out the teaching-learning process. ENDS-IN-VIEW Identify accepted learning theories and their principal constructs. Identify similarities and differences in selected learning theories. Identify appropriate teaching/learning situations where specific theories could be utilized. Actively utilize critical thinking skills in class while examining various philosophies and theories underlying teaching and learning Examine how one s philosophy gives direction to the selection of learning ends-in-view, teaching and evaluation methods. IN PREPARATION: Reflect on your own personal philosophy of teaching and learning. Reflect on your past experiences with teaching and learning. Did learning occur? If so, why? If not, why not? Required Readings: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 3. Mann, K. (2004). The role of educational theory in continuing medical education: Has it helped us? The Journal of Continuing Education in the Health Professions, 24,

23 Harrelson, G. & Leaver-Dunn, D. (2002). Using the experiential learning cycle in clinical instruction. Athletic Therapy Today, September, IN SEMINAR: Through discussion and group activities, we will explore the relevance of different learning theories to specific learners (e.g. individual patients) or groups of learners (e.g. family members) and their needs. We will review components of various theories and apply specific learning theories to examples of clinical teaching. WEBCT: 1) Together, explore the various theories of learning. Which theory of learning is most appealing to you? Why does it make the most sense to you? What are its advantages and limitations? 2) Provide two examples of the effectiveness of your preferred theory in clinical teaching (client/family teaching)? 3) In preparation for next week s work concerning motivation and compliance, develop brief definitions of each of these two concepts. Share your definitions with group members before completing the reading for nest week s class. 23

24 Concept: Determinants of Learning OVERVIEW Nurses are required to teach individuals and groups in a variety of settings. Often, the nurse will face challenges such as lack of time due to shortened lengths of stay. Individuals are at different levels of readiness to receive and process information into something meaningful for them. Nurses may facilitate the process of learning by being sensitive and understanding of the context of individuals/groups and personal perceptions of their learning. Nurses must assess clients to ascertain what determines how well a person learns. ENDS-IN-VIEW Identify what comprises the determinants of learning. Know the steps involved and identify methods to be used in the assessment of learner needs. Explore the four types of readiness to learn and related factors to be assessed. Explore the meaning of learning styles and how to assess individual styles. Explore the process of assessing learner needs and discuss some specific assessment strategies. Examine the importance of learner-centered needs and/or the nurse-educator s role in facilitating motivation to learn. IN PREPARATION Required Readings: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 4. McDonough, J. & Osterbrink, J. (2005). Learning styles: An issue in clinical education?. AANA Journal, 73(2), Some of you may enjoy this online questionnaire for discovering your own learning style! Type the following link in your browser and have fun! 24

25 IN SEMINAR In class, you will have a short lecture on the determinants of learning. Then you will critique a teaching plan and develop your own plan in a small group to teach a topic. You must include strategies to meet the needs of all the learning styles identified by Kolb. WEBCT I would like you to consider an experience in your life where and when you were called upon to teach, educate, mentor, inspire, encourage someone in any capacity (does not have to be in clinical as a student nurse), and when the individual in question was poorly motivated to follow a desirable course of action (i.e. recommendations for health promoting behavior). Reflect on the situation...what were the obstacles/barriers to the individual for learning and implementing health promoting behavior? How were you able to remove or reduce the impact of these barriers? What were the incentives for learning for this individual and how were you able to maximize these for the individual? What new incentives were you able to create to promote motivation and learning? What was the outcome? What would you do differently in future, if faced with a similar situation? 25

26 Concept: Learner Motivation and Compliance OVERVIEW Knowledge alone does not guarantee that the learner will engage in health-promoting behaviors, nor that the desired outcomes will be achieved. The most well-thought-out educational program or plan of care will not achieve the prescribed goals if the learner is not understood in the context of complex factors associated with motivation and compliance. A thorough understanding of the relationship between the reception of information and the application of information, as well as those factors that impede or promote desired health outcomes, is essential for the nurse as educator. (Bastable, 2003) ENDS-IN-VIEW Understand the meaning and theoretic foundations of motivation, compliance, and adherence in relation to behaviors of the learner. Identify incentives and obstacles to motivation to learn. Discuss axioms of motivation relevant to learning. Be able to assess levels of learner motivation. Identify strategies to promote motivation and improve compliance. Be able to identify the components of the Health Belief Model IN PREPARATION Required Readings: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 6. Sedlak, C., Doheny, M, & Jones, S. (2000). Osteoporosis education programs: Knowledge and behaviors. Public Health Nursing, 17(5), IN SEMINAR In class we will explore the concepts of motivation and compliance as they relate to individuals and to families and review a selected health behavior framework and how it influences learning 26

27 WEBCT Reflect on your past experiences with clients. Consider those who have shown motivation to learn and have complied with treatment regimes. Consider those who have not. How were these clients different? What were the incentives and obstacles to learning? What strategies could be used to motivate those who were non-compliant? How would you feel if a nurse called you noncompliant? 27

28 Concept: Health Behaviours OVERVIEW Knowledge alone does not guarantee that the learner will engage in health-promoting behaviors, nor that the desired outcomes will be achieved. The most well-thought-out educational program or plan of care will not achieve the prescribed goals if the learner is not understood in the context of complex factors associated with motivation and compliance. A thorough understanding of the relationship between the reception of information and the application of information, as well as those factors that impede or promote desired health outcomes, is essential for the nurse as educator. (Bastable, 2003) ENDS-IN-VIEW Understand the meaning and theoretic foundations of motivation, compliance, and adherence in relation to behaviors of the learner. Identify incentives and obstacles to motivation to learn. Discuss axioms of motivation relevant to learning. Be able to assess levels of learner motivation. Identify strategies to promote motivation and improve compliance. Be able to identify the components of the Health Belief Model IN PREPARATION Required Readings: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 6. Sedlak, C., Doheny, M, & Jones, S. (2000). Osteoporosis education programs: Knowledge and behaviors. Public Health Nursing, 17(5), IN SEMINAR In class we will explore the concepts of motivation and compliance as they relate to individuals and to families and review a selected health behavior framework and how it influences learning. 28

29 WEBCT Reflect on your past experiences with clients. Consider those who have shown motivation to learn and have complied with treatment regimes. Consider those who have not. How were these clients different? What were the incentives and obstacles to learning? What strategies could be used to motivate those who were non-compliant? How would you feel if a nurse called you noncompliant? 29

30 Concept: Literacy in the Adult Population OVERVIEW An essential prerequisite to implementing patient education programs is knowing a person s literacy skills. (Bastable, 2003) Patients are expected to assume greater responsibility for self-care and health promotion, yet this expanded role depends on increased knowledge and skill. If patients with low literacy abilities cannot fully benefit from the type and amount of information they are typically given, then they cannot be expected to maintain health and manage independently. The result is a significant negative impact on the cost of health care and the quality of life. (Brez & Tayfor, 1997; Brownson, 1998; Fisher, 1999). ENDS-IN-VIEW Understand the terms literacy, illiteracy, health literacy, low literacy, functional illiteracy, reading, readability, comprehension, and numeracy. Identify those at risk for having difficulty with reading and comprehension of written and oral language. Discuss common myths and assumptions about the illiterate person. Identify clues that are indicators of reading and writing deficiencies. Assess the impact of illiteracy and low literacy on patient motivation and compliance with healthcare regimens. Utilize specific formulas and tests to determine readability and comprehension levels of printed materials. Identify teaching strategies useful in educating clients with low literacy skills. IN PREPARATION Required Reading: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 7. IN SEMINAR Today we will examine the impact of literacy issues on healthcare by 30

31 reviewing several studies. We will also review a selection of Patient Education Materials (PEMs) commonly distributed to clients in various healthcare settings (e.g., hospitals, physicians offices, clinics, home care agencies). The class will be divided into groups to review a different PEM for each group. Each group will share their findings with the class and draw conclusions about the appropriateness of these tools for patient education. WebCT Discuss common myths, assumptions and beliefs about people with literacy problems. How does illiteracy challenge individuals in terms of their access to health care? Provide examples. How is the problem of illiteracy addressed in BC? What are some of the resources available to persons with illiteracy? If you discovered that your patient was illiterate, how would you help this individual? 31

32 Concept: Gender, Socioeconomics, and Culture OVERVIEW Understanding diversity, particularly those variations among learners related gender, socioeconomics, and culture, is of major importance when designing and implementing education programs to meet the needs of an increasingly unique population of learners. (Bastable, 2003) ENDS-IN-VIEW Identify gender-related differences in learners based on social and hereditary influences on brain functioning, cognitive abilities, and personality characteristics. Recognize the influence of socioeconomics in determining health status and health behaviours. Become familiar with terms associated with diversity. Explore ways to prepare practitioners to function in a culturally sensitive manner and to be able to do cultural assessments. Explore beliefs and customs of selected cultural groups and identify appropriate teaching strategies for these groups. Become familiar with transcultural nursing and how it can help in meeting the learning needs of various ethnic groups. Identify the meaning of stereotyping, associated risks, and how to avoid this behaviour. IN PREPARATION Required Reading: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 8. IN SEMINAR We will apply gender, socioeconomic status, and culture to the city of Vancouver and look at a model of cultural assessment. 32

33 WEBCT Group 1 Gender-related differences in learners that are based on social and hereditary influences on 1) brain functioning; 2) cognitive abilities; 3) and personality characteristics have been identified. Explain how and why these differences are relevant to nursing practice. Conduct a literature review of current research done on gender differences in learning...you may access credible websites, databases, peer-reviewed journal articles and other sources of information...share your sources of information within the group. What are the predominant findings? What is relevant and meaningful to you as nurses and educators of clients in your care? Group 2 The influence of socioeconomic differences in determining health status and health behaviours is well known. Can you provide examples? What teaching strategies do you think are most effective with individuals who are socially and/or economically deprived? Why? Poverty is a global problem all over the world. In Vancouver, poverty is a significant issue that affects many individuals, families, groups and populations. Who are these individuals and how are their health, health behaviours and access to health care services affected by poverty? Group 3 Review the list of definitions of terms commonly used in dealing with the subject of culture and diversity. Review the four different models of care (Tables 8.1; 8.2; 8.3; 8.4) that address cultural assessment and the delivery of culturally sensitive care. Which of these four models of care explains your own personal and professional views of competent and culturally sensitive care? Explain. Group 4 Review the beliefs, values, customs and health practices of the 4 major culture groups in the US. How are these beliefs, values, customs and health practices significant for nursing practice? What teaching strategies are most effective for the 4 major culture groups in the US? Explain. 33

34 What are the major culture groups in Canada? What are their beliefs, values, customs and health practices? Have you encountered these groups in your nursing practice and/or in your personal lives? What have you learned from these individuals that will influence your nursing practice? Group 5 Review the beliefs, values, customs and health practices of First Nations people. How are these beliefs, values, customs and health practices significant for nursing practice? What teaching strategies are most effective with these individuals and groups? Provide examples. What are some of the social and health issues that most affect this population in Canada. What are some of the strategies that help reduce the burden of these social and health problems for First Nations? Hint: Group 6 Identify the meaning of stereotyping - what are the risks involved for nurses and other health professionals? What are the ways to avoid and prevent stereotyping? Provide examples. Find current research literature in the health sciences that addresses stereotyping. What are the predominant findings and perspectives? How can this research help you to provide culturally sensitive care? Provide examples. Group 7 What is Transcultural Nursing? Where and when did it originate? Who are the pioneers in this field of study? How can this framework help to meet the needs of various ethnic groups? Explore Leininger's work in Transcultural Nursing - see references in your Bastable text. What does this researcher/author attempt to accomplish? How meaningful is it to nursing practice? Interview health care practitioners (MDs, nurses, dietitians, OTs, etc.) who have worked overseas in other countries (do not all interview the same individuals). What were their most powerful learning experiences and how did these experiences shape their own nursing practice? Would you be interested in working with other ethnic groups? Why? 34

35 Concept: Writing Behavioural Objectives and Teaching Plans OVERVIEW Before a decision can be made about selecting the content to be taught or choosing the instructional methods and materials to be used to change learner behaviour, the educator must first decide what the learner is expected to accomplish. Client needs are determined by identifying the gaps in the learner s knowledge, attitudes, or skills. Identification of needs is a prerequisite to formulating behavioural objectives that serve to guide subsequent planning, implementation, and evaluation of teaching and learning. (Bastable, 2003) ENDS-IN-VIEW Understand the differences between goals and objectives. Write clearly stated objectives Explore the three domains of learning. Identify instructional methods appropriate for teaching in each domain. Discuss the importance of learning contracts. Recognize the role of the nurse educator in formulating objectives for planning, implementing, and evaluating teaching and learning. IN PREPARATION Required Reading: Bastable, S. (2003). Nurse as educator: principles of teaching and learning for nursing practice. (2 nd. ed.). Jones and Bartlett Publishers. Chapter 10. IN SEMINAR In class we will practice writing behavioral objectives, using various client scenarios. WEBCT What characteristics are required to make behavioral objectives useful? Provide examples from your own personal lives as students. Develop three behavioural objectives for teaching an adolescent with diabetes self-injection of insulin. Comment on each other s work and learn from one another. 35