Midterm Flashcards
(129 cards)
1
Q
Literacy
A
the ability to understand and use reading, writing, speaking and other forms of communication as ways to participate in society and achieve ones goal and potential
2
Q
Health literacy
A
The degree to which an individual has the capacity to obtain, communicate, process and understand basic health info and services to make appropriate health care decisions
3
Q
60% of adults are unable to
A
-obtain, understand and act upon health
information and services
– make appropriate health decisions on their own.
4
Q
who on average have lower levels of literacy
A
seniors, immigrants, and unemployed
5
Q
what percent of people find it fairly difficult to get medical help
A
23%
6
Q
What percent of people find it fairly difficult to judge when they should go to the doctors
A
54%
7
Q
If someone has literacy skills are they good with health literacy
A
no
7
Q
what are the factors effecting health literacy
A
Influenced by education, culture, social economic status, developmental stage & life experiences
8
Q
4 Links to health literacy
A
ability to Access, comprehend, communicate, evaluate
9
Q
Facets of health literacy
A
community health literacy, health literacy development, health literacy of an individual, health literacy responsiveness
10
Q
Low health literacy leads to
A
-poorer overall health
-misuse of meds
-misunderstanding of health info
-preventable use of EPP
-Waiting longer to seek medical help
11
Q
signs of low health literacy
A
Patient may not follow instructions of recommendations for self care
* High frequency of visits or missing scheduled appointments
* Unable to self-manage condition even after being provided instruction over several visits * May not look at pamphlets or information provided, or may say no when they are offered * When given forms, may decline- “I left my reading glasses at home”
* May bring a family member to visits and defer to them to answer questions
* Noticeable language barrier
* Observing non-verbal signs of lack of understanding (nod and agree)
12
Q
Health disparity by neighborhood income shows significant results in
A
overall health, income security, education, employment
13
Q
People with low income are more likely to
A
attempt suicide, get diabetes, hep C, teen birth, infant die, heart disease, smoke
14
Q
Health promotion
A
the process of enabling people to increase control over and to improve their health
15
Q
Can empowerment be given
A
no only gained when people with little power are able to increase control over resources and decisions
16
Q
Empowerment is an outcome of
A
health promotion activity enhanced literacy and health literacy
17
Q
Patient education hierarchy
A
self determination
unity with personal life
problem solving
treatment general and specific
understanding disease and patho
safety
18
Q
Rn role in health promotion
A
-minimize disparities
-work toward conditions that promote equity and social justice
-support people in gaining control
-provide health info
-teach in a way that meets the needs of the individual
19
Q
CNRS competency for education
A
StandardII:KnowledgeBasedPractice: The registered nurse practices using the evidence informed knowledge, skills and judgement from diverse sources of knowledge and ways of knowing
20
Q
What should documentation include
A
- Document formal and informal teaching
- Description of methods/materials used
- Involvement of patient/family
- Outstanding issues requiring follow-up
- Evaluation of objectives/Pt and Family Comprehension
21
Q
what should be stated in documentation
A
Document formal and informal teaching
2. Description of methods/materials used
3. Involvement of patient/family
4. Outstanding issues requiring follow-up
5. Evaluation of objectives/Pt and Family Comprehension
22
Q
Factors influencing learners assessments
A
- learner needs
- learner readiness
- learning styles
23
Q
nurses barriers to teaching
A
System barriers (lack of time, space, privacy)
* Low importance placed on client education
* Unfamiliar with HOW to teach
* unfamiliar with instructional
design of materials
* unskilled communication practices
24
Patient barriers to learning
System barriers
* Lack of knowledge about body
* Communication issues (language, level of information provided)
* Pain,fear,grief
* Poor health literacy
* No motivation to learn
25
low end education
telling a patient about their medication. Prep for how to teach this learned in school and practiced so many times it will become rout. Is quick and follow up is often complete by other staff, which makes charting essential
26
middle end education
discharge care plan teaching. Reviewing this with the patient, potentially over a few sessions to ensure understanding
27
End of the spectrum
clinical nurse educator, public health nurse, their job is teaching
28
What are the steps in nursing process
assess, plan, implement, evaluate
29
Assessment
determine learning needs, readiness to learn
30
Planning
teaching plan based on mutually developed goals
31
Implementation
perform the act of teaching
32
Evaluation
determine changed in knowledge, attitudes, and skills
33
Patients and families experience better care when
Acknowledge people as experts on their own lives
* Encourage open and honest conversations
* Support pts to understand their options and make decisions about their care
* Look for ways to improve care based in the needs of each pt
34
Communication skills
misunderstandings can be devastating-fatal
* recognize uniqueness of the learner
* structure information so each person can receive, understand, remember and apply it
35
Impact of communication
-Explaining and understanding concerns decreases anxiety levels.
-When patients participate, their levels of satisfaction, compliance, and treatment outcomes increase.
Improved quality of communication is related to positive health outcomes.
36
VARK
Learning styles
-Visual
-Aural
-Written
-Kinaesthetic
-logical
-social
-solitary
37
Universal design for learners
-CAST and UDL
"a framework to improve and optimize teaching and learning for all people based on scientific insights into how humans learn"
38
cultural awareness
* first step to enhance health literacy and reduce inequities
* developing sensitivity/awareness to differences
* not assigning judgment to cultural differences
39
cultural safety
shiftperspectivetowhatmatters for the CLIENT
* "goodnursingcare"witha thorough assessment
* mutualrecognition,mutual respect for differences
* recognizespowerdifferentials and addresses them
* OUTCOMEofculturally competent care
40
cultural competency
focusisonskillof PRACTITIONER not client
* integratingandtransforming your own health knowledge based on knowledge found in other cultures
* reducelongstandinginequities
* improvesaccess,qualityof
service, outcomes
* risk-do'sanddon'tscanleadto assumptions based on traits or attributes
41
primary prevention
“Activities aimed at reducing factors that are known to lead to health problems; prevent the occurrence of disease or injury”
-this is things like safe sex, immunization, annual checkups
42
Secondary prevention
“Activities that seek to detect a disease early in its progression, before signs and symptoms occur, to made a diagnosis and begin treatment; Early detection of and intervention in the potential development or occurrence of a health problem”
-ex HIV screening for injection drug users
Mammogram, PAP test
Accurate blood glucose testing: diabetes
43
tertiary prevention
“The effects of disease become obvious; goals are to interrupt the disease course, to lessen its effects and to prevent further deterioration/recurrence.”
Improve your quality of life and reduce the symptoms from a disease you already have:
Therapy group for mentally ill adults
Physical therapy program for person with spinal cord injury
Walking programs post heart attack
44
methods to assess learner
Informal conversation
Structured interview
Observations- ongoing assessment during caregiving
Documentation
Survey tools/questionnaires (not always available or practical)
45
Things you need to know prior to teaching
1. who the learner is (developmental stage, culture, meaning of illness, what they know already, what they need to know, how they like to learn
2. what are the barriers that prevent their learning
3. what is their motivation
4. What is the most important
5. who will participate
6. how does the learner like to learn
7. understand team goals
8. prioritize needs
9. choose the right setting
10. what resources do I have
11. How much time do I have
46
Determinants od learning
1. learner needs
2. readiness to learn
3. learning styles
47
RN responsibility
: assess when, what they need or want to know and how to adapt content for each learner.
48
PT responsibility
determine what they want to know and adapt the learning based on premise of adult learning
49
Adherence
“The extent to which a person’s behaviour (taking meds, following recommendations, making lifestyle changes) corresponds with agreed recommendations from a health care provider.”
50
Motivation
“Internal state that arouses, directs and sustains behaviour and a willingness to embrace learning.”
Personal attributes
Environment
Relationships
51
Prioritize learning needs
Mandatory (survival, safety)
Desirable (not life dependant but for well being)
Possible (nice to know but not essential)
52
Readiness is defined as
The time when the learner demonstrates interest in learning the information necessary to maintain optimal health"
-when the learner is ready and willing and able to participate
53
PEEK is used for
determining learners readiness
54
PEEK stands for
Physical readiness, emotional readiness, experimental readiness, knowledge readiness
55
Physical Readiness can be influenced by
Health status
Complexity of the task
Gender
Environmental effect
56
Emotional readiness can be determined by
Anxiety
Motivation for learning
Available support systems
Risk taking behaviour
Frame of mind
Developmental Stage
57
Experimental readiness can be determined by
Past experiences
Cultural influences
Coping and control mechanisms
Cultural background/context
Locus of control
Orientation
58
Knowledge readiness is determined by
Level of individual’s current knowledge
Cognitive ability
Learning disabilities
Learning style
59
Health Belief model
-predicts peoples behaviours based on their beliefs about the health problem and health behaviour
60
health model ideas
1. Individual perceptions
How susceptible am I?
How bad do I think this is?
2. Modifying Factors
Demographics (age, gender, culture etc)
Socio-psychological variables (social class, peer influence)
Structural variables (knowledge of disease, prior contact with disease)
3. Likelihood of action
Perceived benefits of preventative action minus perceived barriers to preventative action
"This is going to cost me, but does the benefit outweigh the cost of change?"
60
The stages of change
Precontemplation stage, contemplation stage, action stage, maintenance stage, relapse stage
61
RN Response -prioritzing needs
Approach to prevention: Level 1, 2 or 3
Readiness/motivation
Learning style (VARK, logical, social, alone)
Literacy assessment(health and reading)
62
Preparation stage
Committing to change but still consider what to do
63
Precontemplation stage
not yet contemplating change or unwilling/inable to change- raising awareness stage
64
Contemplation stage
Contemplation-Sees the possibility of change but is ambivalent and uncertain- resolve ambivalence, help to choose change
65
Preparation stage
Committing to change but still consider what to do
66
Action stage
Taking steps towards change but hasn’t stabilized in the change process
67
Maintenance
has achieved goals or relapses- need to either help encourage to stay the course or work at coping with consequences and re-entering a stage to start again in the cycle
68
Approach to pre contemplation stage
-Increase awareness of need for change and personalize the risk and benefit
69
Approach to contemplation
Motivate, encourage and make specific plans
70
Approach to preparation
Assist with developing and implementing concrete action plans help set gradual goal
71
Approach to action
Assist with feedback, problem solving social support and reinforcement
72
Approach to maintenance
assist with coping, reminders, finding alternatives, avoiding slips and relapses
73
Approach to termination
recount the success plan for maintenance over long period of time
74
8 elements of a teaching plan
The purpose
2. The statement of the overall goal
3. List of objectives
4. Outline of content to be covered
5. Instructional method chosen
6. Time allotted for each objective
7. Instructions resources chosen
8. Methods used to evaluate learning
75
RN needs to determine what when making a teaching plan
What needs to be taught when to teach it how to teach it and who to focus the teaching on
76
What is the point of objectives and goals
Provide direction for how to arrive at a specific destination.
*Objectives must be reached before the goal can be reached.
*Goal is the destination and objectives are the pitstops along the way.
*Observable and measurable so RN and the client can determine success
77
How to set a goal
SMART!!!
78
What needs to be considered when making objectives
Need to have internal consistency (Bastable, 2017, pp. 366)
* Need to be clear, concise, realistic and learner centered
* Set realistic goals as unrealistic goals can discourage the pt and sets them up for failure
* Mutual involvement of RN and pt * Learner readiness, motivation
79
Behavioural objectives
statements that describe what the learner will be able to do once they successfully complete a unit of instruction
80
What is a BIG NO in making objectives
Do not describe what the RN will do
81
ABCD model
-Audience (who)
-Behaviour (what/perform)
-Conditions (Under which circumstances)
-Degree (criterion)
82
Audience
-who is the client, what is their literacy, context, determinants of health, what developmental stage
83
Behavioural
what the learner is expected to be able to do and demonstrate the skills that have been learned. Action words
84
Conditions
Situation. under which the behaviour will. be observed or performance that is expected
85
Degree
how well, to what extent, within what time frame
86
two important functions in behavioural objectives
1. provide instructors guidance on selecting materials and ways of teaching
2. Help patient understand what they are expected to learn and understand
87
3 steps to writing clear objectives
1. begin with a constant phrase like learner will or student will
2. Connect step 1 to an action verb which communicates what the learner will do. Use a verb that is measurable
3. Conclude with the specific of what the learner will do when demonstrating achievement. Stress what they will walk away with
88
Performance words
-percise words that describe what the learner will be doing
-knowledge, attitude or a skill
-Performance can be visible: list, write, walk
-Performance can be invisible: indetify, recall, describe
89
Taxonomy
"Way to categorize things according to how they are related to one another."
90
Blooms taxonomy piramid
Create
evaluate
analyze
apply
understand
remember
91
3 learning domains
Cognitive (thinking, Affective (feeling), Psychomotor (skills)
92
cognitive heirarchy
evaluation
synthesis
analysis
application
comprehension
knowledge
93
affective hierarchy
Characterization
organization
valuing
responding
receiving
94
Psychomotor hierarchy
Origination
adaption
complex overt response
mechanism
guided response
set
perception
95
assessment
a process to gather, summarize, interpret, and use data to decide a direction for action.
96
Evaluation
a process to gather, summarize, interpret, and use data to determine the extent to which an action was successful.
97
5 components of evaluation
Audience- who is the evaluation being done for?
* Purpose- why are we evaluating
* Questions- How are we evaluating? What questions will we ask * Scope- who is involved, how big will this get?
* Resources
98
Process evaluation
Audience: individual educator
Purpose: to make adjustments as soon as needed during education process
Question: What can better facilitate learning?
Scope: limited to specific learning experience; frequent; concurrent with learning
Resources: inexpensive and available
99
Content evaluation
Audience: educator/clinician individual or team
Purpose: to determine whether learners have acquired knowledge/skills just taught
Question: To what degree did learners achieve specified objectives?
Scope: limited to specific learning experience and objectives; immediately after education completed (short-term)
Resources: relatively inexpensive; available
100
Outcome evaluation
Audience: educator, education team/director, education funding group
Purpose: to determine effects of teaching
Question: Was teaching appropriate? Were goals met? Did (planned) change occur?
Scope: broader scope, more long term and less frequent than content evaluation
Resources: expensive, sophisticated, may require expertise that is less readily available
101
impact evaluation
Audience: institution administration, funding agency, community
Purpose: to determine relative effects of education on institution or community
Question: What is the effect of education on long-term changes at the organizational or community level? Cost vs Effect?
Scope: broad, complex, sophisticated, long-term; occurs infrequently
Resources: extensive, resource-intensive
102
evaluation process
The process of evaluation in healthcare education is to gather, summarize, interpret, and use data to determine the extent to which an educational activity is efficient, effective, and useful to learners, teachers, and sponsors.
103
Essential elements of a teaching plan
Purose, statement of overall goal, list of objectives, outline of content to be covered, time allowed for teaching, instructional methods, method of evaluate learning
104
assess learner for
What does the learner know already?
◦Knowledge Gaps
◦Learning Style
◦Health Literacy
◦Need to know/want to know ◦Readiness/Motivation ◦Developmental Stage
105
influences of developmental stages
-readiness, rate and capacity for learning, barriers, knowledge of developmental tasks, correct level
106
The 4mat cycle
If (adaption into lives)
Why (meaning)(why should your learner care about this)
What ((concepts)What is vital)
How (skills) how will the learner apply these ideas
107
PITS model(informal beside)
Pathophysiology, indications, treatment, specifics
108
Pathophysiology
What is happening in my body
Any physical/chemical changes in the body that have or could occur as the result of the disease process
*What is normal?
*What is abnormal?
*Helps client to understand “why” of treatment if they better understand the pathophysiology
*Connect dots between pathophysiology and symptoms
109
Indication
Sign and symptoms resulting from injury or disease
*What the patient is experiencing
*what is observed, found on assessment
*Signs or symptoms that may occur because of the disease
*What does this mean for me??
*Talk about treatment of the disease process- generic management *Connect chemical changes (pathophysiology) to physical symptoms *Helps client better understand health status
*Assist with making decisions regarding treatment plans/options
*Beginning understanding of providers view- rationale for what is being recommended and why
110
Treatment
*May differ based on HC team member
*OT: how to use walker, RN: Raise legs, MD: Meds
*Provide treatment information specific to the disease
*Break down complex steps/instructions (ie insulin, weight monitoring, etc.)
*May incorporate educational tools here- addressing disease - NOT patient specific treatment
*Review the previous steps - repetition assists retention and understanding
*Connects new thinking/knowledge with previous knowledg
111
Specifics
Information becomes CLIENT centered Instructions customized to client's context Used in a 1:1 setting
112
Gagnes nine events of instruction
1.Gain attention of the students
2. Inform students of the objectives
3. Stimulate recall of prior learning
4. Present the content
5. Provide learning guidance
6. Elicit performance (practice)
7. Provide feedback
8. Assess performance
9. Enhance retention and transfer to the job
113
Gangnes model of instructional
-exploring
-bridging
-practicing
-enhancing
114
Exploring
Gaining the learner’s attention: foster interest/engagement. *Why should your learner care about this?
*What do learners need to know before presenting new material? *What do they already know? Where are they at now?
*Inform the learner of the purpose of the interaction (objectives)
115
Bridging
*Linking past learning/current knowledge with new information
*What do they need to know?
*Key concepts/essential information/big ideas *Linking content to objectives
*Address 3 domains of learning: knowledge, psychomotor skills, attitude
116
Practicing
*Hands on application of learning
*How will your learner apply these new ideas? * How will they practice/experiment?
* Provide time for practicing
* Provide feedback
* The degree to which learning has been achieved
117
Enhancing
*How will new information be integrated into their own context?
*How can learners adapt these new ideas
*Opportunity to create/evaluate/refine the new information *Giving and receiving feedback
*Assessing degree of learning (knowledge/skill/attitude)
*Suggesting alternate ways for the learner to “try out” the new learning
118
Teaching method
“A teaching method is the way information is taught that bring the learner into contact with what is to be learned”
119
should you only use 1 teaching method
no multiple teaching methods is best
120
examples of teaching methods
*Lecture
*Return demonstrations
*Gaming
*Role playing *Simulation *Self-instruction
121
principles of teaching
Give positive reinforcement (verbal/nonverbal) Attitude
Be organized & give direction
Feedback: Ask for it & Give it
Ask Questions
◦ Factual/Descriptive
◦ Clarifying
◦ Higher level- draw conclusions, analyze, interpret
Teach back/ Tell back
Know the audience Repetition/ Pacing Summarize important points
122
5 components of teaching methods
1. learner assessment and what are the objectives
2. What resources do I have
3. How much time do I have
123
evaluating effectiveness
-does the method help me reach my objectives
-is the learning accessible
-does the method match the time/resources
-are my active participation strategies inclusive of learner needs
124
Principles for choosing instructional materials
Be familiar with the method/material before using it
Materials should COMPLEMENT, REINFORCE, ENHANCE nursing knowledge- not be a substitute
Choice of content should match the content and skills you want the participant to learn
Cost
Instructional aids must fit the physical conditions of the learning environment
◦ Space
◦ Number of people ◦ Lighting
◦ Sound
Match the sensory abilities of the participants Accurate/ Up to date/ Unbiased
125
Choosing instructional materials you must pay attention to 3 variables
1. characteristic of learner
2. Characteristic of the medium
3. characteristic of the task
126
passive learning
receiving info without actually engaging in it
127
Active learning
activities that students do to construct knowledge and understanding.
