Unit 2 Week 7: Assessment Cont'd, Literacy, Teaching Preparation Flashcards

(83 cards)

1
Q

4 Steps to Providing Culturally Sensitive Patient Teaching

A
  1. Examine Personal Culture
    * What and who has shaped us? What are our bias?
  2. Familiarity with patient culture
    * Be a generalist, and curious with our patient’s culture
  3. Identify Adaptations made by patient
    * How do they live out their culture? Do not prescribe what we believe about their culture on to them
  4. Modify Patient teaching based on data from previous steps
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2
Q

What is cultural competence>

A

can be viewed as a process – never fully achieved

Deliberate cognitive process is which we become appreciative and sensitive. Must Involve and begin with assessment of one’s own bias.

  1. self awareness
  2. other awareness
  3. bridging skills
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3
Q

General Assessment and Teaching Interventions for Culturally Competent Care

A
  • Identify client’s primary language
  • Observe interactions between client and family members.
  • Listen to the client.
  • Consider communication abilities and patterns.
  • Explore customs or taboos.
  • Determine the notion of time.
  • Be aware of cues for interaction
  • Assess client’s religious practices.
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4
Q

What to avoid in cultural assessment

A
  • Do not overgeneralize or stereotype patients based on their ethnic heritage
  • Never assume a patient’s learning needs or preferences for health treatment will be alike simply based on ethnicity.
  • We do not want to view all members of a cultural group homogenously or expect certain beliefs or practices presumably.
  • ASSESSING & TAILORING with EACH PATIENT IS VITAL
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5
Q

Define literacy

A

the ability of adults to read, write, and comprehend information at the 8th-grade level or above

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6
Q

Define illiteracy

A

the ability of adults to read, write, and comprehend information at the fourth-grade level or below, or not at all

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7
Q

Define low literacy

A

(marginally literate or illiterate): the ability of adults to read, write, and comprehend information between the fifth to eighth-grade levels of difficulty

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8
Q

Define functional illiteracy

A

in adults, the lack of fundamental reading, writing, and comprehension skills needed to operate effectively in today’s society

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9
Q

Define health literacy

A

“the ability to access, understand, evaluate and communicate information as a way to promote, maintain, and improve health in a variety of settings across the life-course.”

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10
Q

What 4 things should a client with health literacy be able to do?

A
  • Access?
  • Understand?
  • Process and evaluate?
  • Communicate?
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11
Q

_________ + __________ = utilizatoin of health information

A

Context + Skills = Utilization of health information
* Ex) if taught about healthy eating habits, must consider context (poverty/financial stability) and skills (cooking) to be able to utilize the Information

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12
Q

Many people read at least __________ grade levels below their reported grade level of education.

A

2-4

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13
Q

At risk groups for health illiteracy

A
  • Economically disadvantaged
    • Older adults
    • Immigrants
    • English as second language
    • Racial minorities
    • High school dropouts
    • Unemployed
    • Prisoners
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14
Q

Ask me 3 for health literacy

A
  • What is my problem?
  • What do I need to do?
  • Why do I need to do that?
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15
Q

7 Key Strategies to Combat Health LIteracy

A
  1. look for the cues – how would you know?
  2. use audiovisuals
  3. highlight/circle key points on handouts
  4. plain handouts
  5. teach back method
  6. partnerships for self-care
  7. use demonstration
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16
Q

List some telltale signs you should be concerned with literacy

A
  1. reacting to complex learning with withdrawal/avoidance
  2. Excuses: too busy, tired, not feeling well enough to participatie
  3. Lost/broken/forgot glasses
  4. Surrounding themselves with books to give impression they can read
  5. Insist on reading information later
  6. Asking someone to read for them
  7. Being nervous when asked to read
  8. Talking out of context about topic of conversation
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17
Q

How do individuals with poor literacy skils think?

A

in very concrete, specific, and literal terms

  • Characteristics of thinking:
  • Disorganization of thought
  • Limited perception of ideas
  • Slow rate of vocabulary and language development
  • Poor problem-solving skills
  • Difficulty analysing and synthesizing information
  • Difficulty formulating questions
  • Struggles when handling more than one piece of information at a time
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18
Q

Poor outcomes associated with decreased functional health literacy

A
  • Increased morbidity and mortality
  • Poorer adherence
  • More medication errors
  • Decreased ability to interpret labels and health messages
  • Dependence (decreased autonomy and empowerment)
  • Increased use of ERs or EMS
  • Increase in re-admission
  • Decrease in overall health status and wellness
  • Decrease in use of preventative services
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19
Q

3 P’s of Health Literacy

A

Plain, Personal, Possible

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20
Q

What reading grade level should PEM be kept at?

A

4-5

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21
Q

7 Things to Consider when Evaluating Printed Materials

A
  • Nature of the audience
  • Literacy level required
  • Linguistic variety available
  • Brevity and clarity
  • Layout and appearance
  • Opportunity for repetition
  • Concreteness and familiarity
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22
Q

PEM should use an _____ voice

A

active

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23
Q

PEM should write _____ to the reader ______

A

directly
reader

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24
Q

PEM should include ____ terms with no _______

A

simple
jargon

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25
PEM should use _____ sentences/_______ points
short bullet
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PEM should ______ key information
highlight
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PEM should write instructions in order of __________
enactment
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Assessment of Instructional Material Understandability: The material makes its _________ completely evident The material does not include ______ The material uses _________ language The material provides a _________ The visuals _____ rather than _________
purpose information or content that distracts from its purpose common, everyday language summary reinforce distract
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Assessment of Instructional Material Actionability The material identifies: The material breaks down action into: The material provides a ______ whenever it could help the user act
At least one action the user can take Manageable, explicit steps tangible tool
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Learners typically read at least _____ grade levels lower than their highest level schooling
two
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Flesch-Kincaid Scale
Readability Formula - appropriate for grade 5 to university levels - uses average sentence length (in words) and average word length (in syllables)
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Cloze Procedure
Comprehension Test - does not provide grade level rating - measures ability to comprehend written material - administered to patients who demonstrate difficulty reading/comprehension at a grade 6 level - every 5th word is removed and patient asked to fill in blank - easier the material to comprehend = higher score
33
Listening Test
Comprehension Test - measures ability to comprehend verbally delivered - can be used for low literacy (below grade 6) - choose a grade.5 level sample that takes around 3 minutes to read - formulate 5-10 questions around key information - Ask questions and grade as correct answers < 75%: needs to be simplified 75-89: additional assistance in comprehension required >90%: easily understood
34
Teaching Strategies for Hearing Deficits
* Use natural speech patterns; do not over articulate. * Use simple sentences. * Get attention of the client by a light touch on arm. * Face the client, standing no more than 6 feet away. * Avoid standing in front of bright light, which obscures your face. * Minimize motions of your head while speaking. * Refrain from placing IV in hand that the client needs for sign language.
35
Teaching Strategies for Visually Impaired
* Secure services of a low-vision specialist to obtain adaptive optical devices. * Avoid the tendency to shout and to use nonverbal cues. * Always announce your presence and identify yourself. * Allow the client to touch, handle, and manipulate equipment * Be descriptive in explaining procedures. * Use large font size for printed or handwritten materials. * Avoid color; rely on black and white for printed materials. * Use alternative instructional tools that stimulate auditory and tactile senses
36
Define learning disability and give 3 examples
Heterogeneous group of disorders of listening, speaking, reading, writing, reasoning, or mathematical abilities. - may have normal or superior intelligence * Dyslexia * Auditory processing disorders * Dyscalculia
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4 Domains of Learning Disabilities
1. The academic domain - includes reading, written expression, spelling and mathematics. 2. The information-processing domain- includes how information is received through the senses, attended to, perceived, organized, stored in memory, retrieved and expressed. 3. The social/adaptive domain encompasses social competence that involves the ability to engage successfully in interpersonal relationships and adapt to the environment. 4. The communication domain- includes auditory skills, receptive language skills, expression of language. thinking hypothetically or understanding jokes/puns
38
Accommodations and 3 Types
A change or alteration to the regular way a person is expected to learn, complete projects or participate in activities. Accommodations lessen or remove the impact of a person’s learning disability giving them more equal opportunities to succeed. 1. Environmental 2. Instructional/Assignment 3. Evaluation/Testing
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Developmental Disability and 3 Examples
A severe chronic disability that is present before 22 years of age likely to continue indefinitely Include: * Attention-deficit/hyperactivity disorder * Intellectual disabilities * Autism spectrum disorder
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Define intellectual Disabilities and 3 Examples
Defined as an intellectual condition that originates before the age of 18 that results in impaired reasoning, problem solving, and adaptive behaviors. IQ is low on an IQ test o Down syndrome o FAS o Neurological impairments suffered in utero, or through birth trauma, LBW
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In intellectual disabilities _____ and _________ of RN is important
tone and facial expression
42
Teaching stratgies for Mental Illness
* Teach by using small and brief words, repeating information over and over * Keep sessions short and frequent * Involve all possible resources, including client and family
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Acquired brain injury teaching strategies
* Use group teaching approach. * Involve immediate caregiver. * Invite rehabilitated patients to share experiences. * Conduct family group sessions. * Focus on client safety and family coping. * Give step-by-step instructions. * Allow time for responses. * Provide small amounts of information. * Keep sessions short.
44
Teaching strategies for Cognitive Disorders
* Emphasize memory techniques that focus on the need for attention, repeating information, and practicing retrieval * Encourage client to take notes * Assist client to create a system of reminders * Emphasize memory techniques that focus on the need for attention, repeating information, and practicing retrieval * Encourage client to take notes * Assist client to create a system of reminders * Incorporate visualization * Teach clients to “chunk” information * Arrange brief, frequent repetitive sessions to provide constant reinforcement
45
Aphasia vs Dysarthria (Communication Disorders)
Aphasia: a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language. Aphasia usually happens suddenly after a stroke or a head injury. Dysarthria: Dysarthria is where you have difficulty speaking because the muscles you use for speech are weak. It can be caused by conditions that damage your brain or nerves and some medicines.
46
Teaching Strategies for Aphasia
Encourage and praise participation. Acknowledge client’s frustrations. Keep distractions to a minimum. Speak slowly using a normal tone and short sentences. Have only one person speak at a time. Stand where the client can see your face. Check to be sure each message is understood. Allow each person time to respond
47
Teaching Strategies for Dysarthria
* Ensure a quiet environment. * Encourage concentration and intention to improve speech clarity. * Ask questions that need only short replies. * Use alternative methods of communication. * Encourage client to speak slower and louder. * Do not simplify message because the client’s comprehension is not affected.
48
Teaching Strategies for Chronic Illness
* Acknowledge loss or change in roles. * Recognize effects of illness on self-esteem. * Emphasize regimens that match physical strength. * Individualize instruction relevant to problems encountered. * Encourage integration of new knowledge for problem-solving. * tell the person they are about to hear important info. “I want you to remember this” * provide a count of details. There are 5 reasons why…. * use index cards with question on one side, answer on the other * create chants, rhymes, acronyms, crazy phrases to remember lists, multiplication tables etc.
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Goals vs Objectives
Goals - global - broad - longterm - multidimensional Objectives - specific - singular - short-term - unidimensional
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3 Types of Objectives
1. Educational 2. Instructional 3. Behavioural
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Define educational objective
Assess the intended outcomes of the education process. Nursing example: The objectives of a cardiac rehabilitation patient program
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Define instructional objective
The teaching activities and resources utilized to facilitate learning. Nursing example: Group sessions & exercise drop in for cardiac rehab
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Define behavioural objective
also referred to as learning objectives - action orientated, describe what learner will aim to do following a learning situation. Nursing example: Pt. will gain an accurate understanding of the importance of behavioral change within cardiac rehabilitation after completing the five program sessions.
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The Importance of Using Behavioural Objectives
* Keeps teaching learner-centered * Communicates plan to others * Helps learners stay on track * Organizes educational approach * Ensures that process is deliberate * Tailors teaching to learner’s needs * Creates guides for teacher evaluation * Focuses attention on learner * Orients teacher and learner to outcomes * Helps learner visualize skills
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What is Blending?
Occurs when the professional (nurse as teacher) and client (learner) collaborate and mutually decide on objectives. The focus is on results not the act of teaching.
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3 Important Characteristics of Behavioural Objectives
1. Performance: What the learner is expected to do that will evidence objectives have been achieved 2. Condition: Describes condition under which behaviour will occur 3. Criterion: Time frame + level of competence the learner will strive to achieve
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ABCD Rule
4 Step Method of What to Include in Objectives Audience (who) Behaviour (what) Condition (under what circumstances) Degree (how much, to what extent)
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Common Mistakes When Writing Objectives
1. focus on what instructor will do 2. including > 1 behaviour in a single objective 3. Forgetting to include the BCD characteristics (behaviour, condition, degree) 4. Using performance terms subject to many interpretation 5. unattainable/unrealistic 6. Objectives unrelated to stated goal 7. Cluttering with unnecessary information 8. Too general so outcome is not clear 9. Not altering/evaluating as you go
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What is Bloom's Taxonomy of Objectives
A longstanding educational theory that identifies things that need to be able to happen at baseline levels before moving to higher levels of learning.
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6 Levels of Cognitive Domain Levels from lowest to highest level skill
1. Knowledge 2. Comprehension 3. Application 4. Analysis 5. Synthesis 6. Evaluation
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Knowledge Verbs
Defines Describes Identifies Labels Lists Names States
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Comprehension Verbs
Discusses Estimates Explains Gives examples Identifies Locates Paraphrases Reports Restates Summarizes
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Application Verbs
Apply Changes Computes Demonstrates Modifies Operates Prepares Produces Relates Selects Solves Uses
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Analysis Verbs
Analyzes Arranges Breaks down Compares Differentiates Illustrates Infers Outlines Relates Sorts Selects Categorizes Criticizes Detects
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Synthesis Verbs
Arranges Categorizes Combines Compiles Composes Designs Formulates Generates Modifies Organizes Plans Relates Reconstructs Revises Summarizes
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Evaluation Verbs
Appraises Assesses Compares Concludes Contrasts Criticizes Debates Defends Evaluates Judges Justifies Revises Scores Summarizes Supports
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Cognitive knowledge is an _________ for learning affective and psychomotor skills.
essential prerequisit
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3 Stages of Motor Learning
Cognitive Associative Autonomous
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Psychomotor Domain Levels from Lowest to Highest Level Skill
1.Perception 2.Set 3.Guided Response 4.Mechanism 5.Complex Overt Act 6.Adaptation 7.Origination
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Perception Verbs
Chooses Describes Detects Differentiates Identifies Selects Separates
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Set Verbs
Copies Displays ExpressesMoves Positions Proceeds Reacts Responds Shows
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Guided Response Verb
Applies Assembles Demonstrates Discriminates Dismantles Manipulates Operates Organizes Simulates Solves
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MECHANISM OR COMPLEX OVERT RESPONSE verbs
Examines Finds Practices Reassembles Tests
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Adaptation Verbs
Adapts Alters Changes Corrects Creates Designs Modifies Rearranges Reorganizes Revises Shifts Substitutes Varies
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Origination Verbs
Arranges Builds Combines Creates Designs Originates Produces
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__________ that demand a cognitive or affective response during psychomotor learning interferes with psychomotor performance.
Asking questions
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Affective Domain Levels from lowest to highest level
1.Receiving 2.Responding 3.Valuing 4.Organizing 5.Characterizing
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Receiving Verbs
Accepts Asks Attends Focuses Follows Listens Observes
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Responding Verbs
Agrees Answers Complies Chooses Complies Discusses Practices Presents Selects
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Valuing Verbs
Askes Accepts Chooses Completes Defends Explains Follows Initiates Justifies Selects Shares
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Organization Verbs
Adheres Alters Arranges Chooses Combines Commits Completes Defends Explains Integrates Modifies Relates Resolves
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Characterizing Verbs
Acts Adheres Commits Continues Discriminates Defends Displays Endures Explains Influences Modifies Performs Practices Uses
83