Health Education Process Abeer Shaheen Outline Process of

Health Education Process Abeer Shaheen

Outline �Process of health education To assess the patients’ learning needs 1. Steps in assessment of learning needs Barriers to identification of needs Factors in teaching learning Situation � � � To establish the teaching and learning objectives 2. � � Characteristics of goals and objectives Advantages of behavioral objectives Common mistakes when writing objectives 3. To Constitute the teaching plan 4. To implement the teaching plan 5. To evaluate the teaching and learning �

Outline � Reasons of constructing a teaching plan. � Eight basic parts of a teaching plan. � Sample of Teaching Plan. � Evaluating the Health teaching. � Definition of Instructional methods. � Selection of instructional methods. � Types of instructional methods. � Evaluation of instructional methods � Techniques to enhance effectiveness of teaching: � Definition of Instructional Materials. � Choosing instructional materials � Variables to consider in choosing instructional materials � The three major components of instructional materials � Types of instructional materials

Process of Health Education A. To assess the patients’ learning needs B. To establish the teaching and learning objectives C. To Constitute the teaching plan D. To implement the teaching plan E. To evaluate the teaching and learning

A. To Assess the Patient’s Learning Needs Steps in assessment of learning needs: 1. Identify the learner 2. Collect data on the learner 3. Include the learner as a source of information 4. Choose the right setting 5. Involve members of the health care teams. 6. Prioritized needs.

Steps in Assessment of Learning Needs: 1. Identify the learner �Who is the audience? �If more than one learner, are their needs congruent or diverse? 6

Steps in Assessment of Learning Needs: 2. Collect data on the learner �Determine characteristics need of the population by exploring typical health problems or issues of interest to that population. 7

Steps in Assessment of Learning Needs: 3. Include the learner as a source of information �Actively engaging learners in defining their own problems and needs allow them to learn because they have an investment in planning for a program. 8

Methods to assess learning needs from learner: � Informal conversation—learning needs can be discovered during any conversation between the nurse and family. The nurse must rely on active listening. � Structured interviews—the nurse asks the learner direct and often predetermined questions to gather information about learning needs. � Observations

Barriers to identification of needs: Teacher (barriers to perception of client's needs) �Does not listen or respond to client's question. �Lack of knowledge to deal with question. �Has insufficient information about client. �Discourages client participation to maintain control. �Lacks time due to poor ward organization or inadequate staffing. �Lack of confidence. 10

Barriers to identification of needs: Learner (Barriers to expression of needs) �Reluctant to ask questions �Lacks language to request technical information �Perceives professionals only helpers, not teacher or informants. �Adopt passive role readily. �Not ready or motivated to participate. �Convinced by previous experiences that expression of needs is not welcomed. �Does not consider health teaching part of the nurse's role. 11

Steps in Assessment of Learning Needs: 4. Choose the right setting �Establishing a trusting environment will help learners feel a sense of security in confiding information, believes their concern are taken seriously and feel respected. 12

Steps in Assessment of Learning Needs: 5. Involve members of the health care teams �Nurses are not the only teacher and must remember to collaborate with other members of the health care teams. 13

Steps in Assessment of Learning Needs: 6. Prioritized needs �Maslow's hierarchy of human needs help the educator prioritize identified learning needs. Assist the learner to meet basic needs first. Learning of other needs will be delayed if basic needs are not attended first and foremost. 14

Prioritized Needs

Factors in teaching learning Situation Environment �Space �Noise �Furniture �Time �Material Resources �Support from the system �Expectations 16

Factors in teaching learning Situation Learner �Motivation �Capacities �Energy �Culture and age �Intelligence and skills �Emotional and physical state �Values and experience �Learning style 17

Factors in teaching learning Situation Teacher �Motivation �Capacities �Knowledge �Energy �Beliefs and Values �Communication Skills �Selection of methods and materials �Teaching style 18

B. To Establish Teaching and Learning Objectives �Educational or instructional objectives �Use to identify the intended outcomes of the education process, whether in reference to an aspect of a program or total program of the study. �Behavioral or learning objectives �Action oriented rather than content oriented and learner centered rather than teacher centered.

Educational Objectives �Goal—the final outcome of what is achieved at the end of teaching learning process. Broad in nature and serve as a long term targets for both the learner and teacher. �Objective—specific, single, one-dimensional behavior. Short term in nature and should be achievable at the conclusion of teaching sessions or within a matter of few days.

Characteristics of goals and objectives � Objective must be achieved before the goal can be reached � Goals and objectives must be observable and measurable to be able to determine if they have been met by the learner. � Objectives are derived from the goal and must be consistent with and related to that goal.

Characteristics of goals and objectives � Objectives and goals must also be clearly written, realistic and learner centered. � Objectives and goals must be directed to what the learner is expected to be able to do, not what the teacher is expected to teach. � together objectives and goals forms a map giving directions (objectives) as how to arrive at particular destination (goals)

Example: �Goal: the group of diabetic patient will learn to manage diabetes after one week �Objectives: �After 4 hours of discussion the group of diabetic patient will be able to list a diabetic diet planned menu for 2 days. �After watching the demonstration on self glucose monitoring the group of diabetic patient will be able to do the correct procedure for self glucose monitoring. �After watching the demonstration on self insulin administration the group of diabetic patient will be able to correctly administer insulin. �On completing the reading materials provided on diabetic exercise regimen the group of diabetic patient will be able to list down 3 out of 5 importance of exercise regimen for diabetic.

Advantages of behavioral objectives: � Helps to keep educators thinking on target and learner centered. � Communicates to others, both learners and health care team members alike, what is planned for teaching and learning. � Helps learner understand of what is expected of them, so they can keep track of their progress. � Forces the educator to organize educational materials so as not to get lost in content and forget the learner's role in the process.

Advantages of behavioral objectives: � Tailors teaching to the learner's particular needs. � Serves as a guidepost for teacher evaluation and documentation of success or failure. � Orient the teacher and learner to the specific end of instruction. � Make it easy for the learner to actually visualize performing the required action.

Three important characteristics of writing concise and useful behavioral objectives: 1. Performance—describe what the learner is expected to be able to do or perform to demonstrate the kinds of behaviors the teacher will accept as evidence that objectives have been achieved. 2. Conditions—describe the testing situation or constraints under which the behavior will be observed or the performance is expected to occur. 3. Criterion—describes how well or with what accuracy the learner must be able to perform for the behavior to be considered acceptable.

Example of the three characteristics of behavioral objectives: 1. Performance (learner behavior): The learner will be able to: 1. Solve, 2. Demonstrate, 3. List, 4. Select, 5. Identify, 6. Define, 7. Write 2. Condition (testing situation): 1. Following group discussion. 2. Following a class. 3. After watching a video. 4. After watching a demonstration. 5. On completing the reading materials. 3. Criterion (quality of accuracy): 5 out of 6 problems, The correct procedure, At least two reason, With 100 % accuracy.

Steps in Writing Behavioral Objectives: 1. Identify the testing situation (condition) 2. State the learner (who) and the learners behavior (performance) 3. Conclude by stating the performance level (criterion)

Example: well-written objectives �"Following a 30 minutes teaching session on hypoglycemia (condition), Mr. Ali will be able to identify (performance) three out of four major symptoms of low blood sugar (criterion). �After watching the demonstration on self glucose monitoring the group of diabetic patient will be able to do the correct procedure for self glucose monitoring. �Following a class on hypertension, the patient will be able to state three out of four causes of high blood pressure.

Common mistakes when writing objectives: � To describe what the instructor rather than the learner is expected to do. � To include more than one expected behavior in a single objective (avoid using the compound word and—e. g. , the patient will select and prepare). � To forget to include all three components of condition, performance, criterion.

Common mistakes when writing objectives: � To use terms for performance that are subject to many interpretations, not action oriented and difficult to measure. � To write an objective that is unattainable given the ability of the learner. � To write objective that do not relate to the stated goal.

Example: poor written objectives � the patient will be able to prepare a menu using low salt foods (condition and criterion missing) � given a list of exercises to relieve low back pain, the patient will understand how to control low back pain (performance not stated in measurable terms, criterion missing) � to demonstrate crutch walking postoperatively to the patient (teacher-centered)

Verbs recommended and avoided to be used in performance Terms with many interpretation (should be avoided): to know, to understand, to appreciate, to realize, to be familiar with, to enjoy, to value, to be interested in, to feel, to think. Terms with few interpretation (recommended) to apply: to explain, to choose, to identify, to classify to list, to compare, to order, to contrast, to predict, to construct to recall, to define, to recognize, to describe to select, to demonstrate, to select, to differentiate to verbalize, to distinguish, to write.

Taxonomy of objectives according to learning domains �Taxonomy—a mechanism used to categorize things according to their relationship to one another. �Taxonomy of behavioral objectives �develop by bloom et al. (1956) �A tool for systematically classifying behavioral objectives. �It became widely accepted as a standard aid for planning as well as evaluating learning, it is divided into three learning domains.

Three learning domains 1. Cognitive domain. 2. Affective domain. 3. Psychomotor domain.

Three learning domains 1. Cognitive domain: The "thinking domain". Refers to acquisition of information through the learner's intellectual abilities, mental capacities, and thinking processes.

Three learning domains 2. Affective domain. The "feeling" domain. Learning in this domain involves an increasing internalization or commitment to feelings expressed as emotions, interests, attitudes, values and appreciations. It is divided into categories that specify the degree of a person's depth of emotional response to tasks. Affective learning is a part of every type of educational experience even though the primary focuses for learning may be on either the cognitive or psychomotor domain.

Three learning domains 3. Psychomotor domain: The "skills" domain. Learning in this domain involves acquiring fine and gross motor abilities with increasing complexity of neuromuscular coordination to carry out physical movement such as walking, handwriting, manipulation of equipment, or carrying out procedure. Psychomotor skills are easy to identify and measure because they include primarily movement-oriented activities that are relatively observable.

Levels of Cognitive Domain 1. Knowledge 2. Comprehension 3. Application 4. Analysis 5. Synthesis 6. Evaluation

Levels of Cognitive Domain 1. Knowledge—the ability of the learner to memorize, recall, define, recognize or identify specific information, such as facts, rules, principles presented during instruction 2. Comprehension—ability of the learner to demonstrate an understanding or apprehension of what is being communicated by translating it into a different form or recognizing it in a translated form. e. g. , grasping an idea by defining or summarizing it in his own words. (knowledge is prerequisite behavior)

Levels of Cognitive Domain 3. Application—ability of the learner to use ideas, principles, abstractions or theories in particular and concrete situations, such as figuring, writing, reading or handling equipment (knowledge and comprehension are prerequisites behavior) 4. Analysis—ability of the learner to recognize and structure information by breaking it down into its constituent part and specifying the relationship between parts. (knowledge, comprehension and application are prerequisites behavior)

Levels of Cognitive Domain 5. Synthesis—ability of the learner to put together parts and elements into a unified whole by creating a unique product that is written, oral, or pictorial. (knowledge, comprehension, application and analysis are prerequisites behavior 5. Evaluation—ability of the learner to judge the value of something, such as an essay, design, or action by applying appropriate standards or criteria. (knowledge, comprehension, application, analysis and synthesis are prerequisites behavior)

Examples of behavioral objectives according to cognitive domain �Analysis level: �After reading handouts provided by the nurse educator, the family member will calculate the correct n number of total grams of protein included on average per day in the family diet. �Synthesis level: �Given a sample list of foods, the patient will devise a menu to include foods from the food groups (dairy, meat, vegetables, fruits and grains) in the recommended amount of daily intake.

Teaching methods in cognitive level: 1. Lecture 2. One-to-one instruction 3. Computer assisted instruction the use of verbal, written, and visual tools are all particularly successful in supplementing the teaching methods to help learner master cognitive contents

Levels of Affective Domain (Categories): 1. Receiving—ability of the learner to show awareness of an idea or fact or a consciousness of a situation or event in the environment. It represents willingness to selectively attend to or focus on data or to receive a stimulus. 2. Responding—ability of the learner to respond to experience, at first obediently and later willingly and with satisfaction. . . (receiving is a prerequisite behavior)

Levels of Affective Domain (Categories): 3. Valuing—ability of the learner to regard or accept the worth of a theory, idea or event, demonstrating sufficient commitment or preference to be identified with some experience seen as having value and a definite willingness and desire to act to further that value. (receiving and responding are a prerequisites behavior)

Levels of Affective Domain (Categories): 4. Organization—ability of the learner to organize, classify and prioritize values by integrating a new value into general set of values, to determine interrelationships of values, and to harmoniously establish some as dominant and pervasive. (receiving, responding and valuing are a prerequisites behavior) 4. Characterization—ability of the learner to integrate values into a total philosophy or world view, showing firm commitment and consistency of responses to the values by generalizing certain experiences into a value system or attitude clusters. (receiving, responding, valuing and organization are a prerequisites behavior)

Examples of behavioral objectives in affective domain: �Receiving level: �During a group discussion session, the patient will admit to any fears he may have about needing to undergo a repeat angioplasty. �Responding level: �At the end of one-to-one instruction, the child will verbalize feelings of confidence in managing her asthma using the peak flow tracking chart �Characterization level: �Following a series of in-service education session, the staff nurse will display consistent interest in maintaining strict hand washing technique to control the spread of nosocomial infections to patients in the hospital.

Teaching methods used in the affective domain: 1. Questioning 2. Case study 3. Role playing 4. Stimulation gaming—a process games, controlled by participants and with flexible rules. 5. Group discussion

Levels of Psychomotor Domain: 1. Perception—ability of the client to show sensory awareness of objects or cues associated with some tasks to be performed. It involves reading directions or observing a process with attention to steps or techniques inherent in a process. 2. Set—ability of the learner to exhibit readiness to take a particular kind of action such as following directions, through expression of willingness, sensory attending or body language favorable to performing a motor act. (perception is a prerequisites behavior)

Levels of Psychomotor Domain: 3. Guided response—ability of the learner to exert effort via overt actions under the guidance of an instructor to imitate an observed behavior with conscious awareness of effort. (perception and set are prerequisites behaviors) 4. Mechanism—ability of the learner to repeatedly perform steps of desired skills with a certain degree of confidence, indicating mastery to the extent that some or all aspect of the process becomes habitual. (perception, set and guided response are prerequisites behaviors)

Levels of Psychomotor Domain: 5. Complex overt response—ability of the learner to automatically perform a complex motor act with independence and a high degree of skill without hesitation and with minimum expenditure of time and energy. Performance of an entire complex behavior without the need to attend to details. (perception, set, guided response and mechanism are prerequisites behaviors)

Levels of Psychomotor Domain: 6. Adaptation—ability of the learner to make modifications or adaptations in a motor process to suit the individual or various situations, indicating mastery of highly developed movements that can be suited in variety of conditions. ) (perception, set, guided response, mechanism and complex overt response are prerequisites behaviors)

Levels of Psychomotor Domain: 7. Origination—ability of the learner to create new motor acts, such as novel ways of manipulating objects or materials, as a result of understanding of a skill and developed ability to perform skills. (perception, set, guided response, mechanism, complex overt response and adaptation are prerequisites behaviors)

Examples of behavioral objectives in the psychomotor domain: �Set level: �Following demonstration of proper crutch walking, the patient will attempt to crutch walk using the correct three point gait technique. �Guided response level: �After watching a 15 -minute video on the procedure for self examination of the breast, the client will perform on a model with 100% accuracy.

Teaching methods use in psychomotor domain: �Demonstration and return demonstration

Factors that affect the individual to learn new skills: 1. Readiness to learn—the motivation to learn affects the degree of perseverance exhibited by the learner in working toward mastery of a skill. 2. Past experience—if the learner is familiar with equipments or techniques similar to that being needed to learn a new skill, then mastery of the new skill may be achieved at a faster rate.

Factors that affect the individual to learn new skills: 3. Health status—illness state or other physical or emotional impairments in the learner may impact on the time it takes to acquire or successfully master a skill. 4. Environmental stimuli—depending on the type and level stimuli as well as the learning style (degree of tolerance to a certain stimuli), distraction in the immediate surroundings may interfere with skills acquisition.

Factors that affect the individual to learn new skills: 5. Anxiety level—ability to concentrate can be highly affected by how anxious someone feels. Anxiety levels interfere with coordination, steadiness, fine muscle movements and concentration levels when performing complex skills. 6. Developmental stage—certainly a young child's fine and gross motor skills as well as cognitive abilities are at different level than those of adult.

Factors that affect the individual to learn new skills: 7. Practice session length—during the beginning stages of learning a motor skills, short and carefully planned practice session and frequent rest periods are valuable techniques to help increase the rate and success of learning.

Three major reasons of constructing a teaching plan: 1. To force the teacher to examine the relationship among the steps of the teaching process to ensure a logical approach to teaching, which can serve as a map for organizing and keeping instruction on target. 2. To communicate in writing and in an outline format exactly what is being taught, how it is being taught and evaluated, and the time allotted for the accomplishment of the behavioral objectives. 3. To legally document that an individual plan for each learner is in place and is being properly implemented.

Eight Basic Parts of A teaching Plan: 1. The purpose 2. Statement of overall goal 3. List of objectives (sub objectives, if necessary) 4. Outline of the related content 5. Methods of presentation 6. Time allotted for the teaching of each objective 7. Instructional resources (materials/tools) 8. Methods of evaluation of learning.

Sample of Teaching Plan 1. Purpose: To provide with information necessary for self administration of insulin as prescribed. 2. Goal: The patient will be able to perform insulin injections independently according to treatment. 63

Sample of Teaching Plan 4. Objectives and Sub objectives : Following a 20 minute teaching session, the patient will be able to: Identify the 5 sites for insulin injection with 100%. 5. Content Outline Location of 5 anatomical sites. Rotation sites accepted technique according to procedure. 64

Sample of Teaching Plan 6. Methods of Presentation demonstration 7. Time Allotted (in minute)5. 8. Resources Anatomical chart. handouts 9. Methods of Evaluation circle 5 anatomical locations on an anatomical chart 65

Evaluating the health teaching �Evaluation is an essential and inevitable part of teaching- learning process. �Whether or not the teacher plans for it to happen, both learner and teacher will evaluate, whether formally or informally. �Both teacher and learner need detailed and constructive feedback. 66

Evaluating the health teaching The teacher should not be content with an intuitive sense that all went well, but should attempt to identify exactly what has been achieved. 67

Definition of Evaluation is a planned process and should be continuous; it is made in regard to stated criteria, which may be developed and applied by both teacher and learner, and may involve measurements. 68

Evaluating learning � Knowledge: essential for changing behavior � Attitude: precondition for changing behavior � Behavior: predetermined outcome of health education 69

Instructional Methods �Instructional methods: are the techniques or approaches the teacher uses to bring the learner into contact with the content to be learned. �Teaching effectively is a learned skill. Development of these skills requires knowledge of the educational process including the instructional methods available and how to use them with a variety of learners and settings

Instructional Methods �When learners know what is expected of them, they learn regardless of the methods or tools used for teaching (haggard, 1989). However, the teacher function is a vital role by providing guidance, and support for learning. �In addition, the use of appropriate methods to meet the needs of the learners should not be underestimated.

Selection of instructional method: �The process of selecting an instructional method requires a prior determination of the behavioral objectives to be accomplished an assessment of the learners who will involved in achieving the objectives. �Consider the following criteria: �available resources (time, money, space, materials to be used for learning) �audience/learner �the content to be taught �the teacher

Selection of instructional method: �the ideal method for any given situation is the one that best suits the learner's needs, not the teacher own but teachers are likely to focus on a particular method because it is the one they feel most comfortable using without considering all the criteria for selection.

Types of Instructional Methods �Traditional Methods �lecture �one-to-one instruction �group discussion �demonstration and return demonstration. �Non-Traditional Method �gaming �self instruction activities �simulation �computer assisted instruction �role-playing �Distance learning �role-modeling.

Traditional Methods of Teaching: Lecture �a highly structured method by which the teacher verbally transmits information directly to groups of learner for the purpose of instruction. �it can be an effective method of teaching in the lower-level of cognitive domain to impart content knowledge.

Traditional Methods of Teaching: Lecture �Advantages: �useful to demonstrate and highlight main idea. �efficient and cost-effective method for getting large amount of information across to a large number of people all at the same time. �can be easily supplemented with handout materials and other audiovisual aid.

Traditional Methods of Teaching: Lecture �Limitations/disadvantages: �ineffective in influencing affective and psychomotor behavior. �does not provide for much stimulation of learners. �less opportunity for learner involvement. �Instructor centered. �learners are exposed to the same information regardless of ability or need.

Traditional Methods of Teaching: Group discussion �a method of teaching whereby learners get together to exchange information, feelings, and opinion with each other and the teacher. �the group size can vary, but most group discussion techniques can be used with a few as 3 people and as many as 15 -20 people.

Traditional Methods of Teaching: Group discussion �Advantages: �stimulate learners to think about issues and problems �makes learning more active because learner can exchange their own experiences. �active learning leads to greater retention of information (Haggard 1989). �provides opportunities for sharing of ideas, receiving peer support, fostering a feeling of belonging, giving guidance and reinforcing previous learning.

Traditional Methods of Teaching: Group discussion �Limitations/disadvantages: �one or two members tend to dominate the discussion which may lead shy members not to participate. �requires the teacher presence during each session to act as a facilitator and resource person. �takes more time to transmit information via this method than in any other methods.

Traditional Methods of Teaching: One-to-one instruction �a method in which the teacher delivers individual instruction designed specifically for a particular learner. �it is an opportunity to communicate ideas and feelings primarily through oral exchange and also non verbal messages. Questioning is an excellent strategies for this method.

Traditional Methods of Teaching: One-to-one instruction �Advantages: �individualize teaching—can be tailored to meet individual needs. �serves as an ideal intervention for initial assessment and continued evaluation of the learner in all three domains of learning. �suitable for teaching those who are educationally disadvantaged or who have been diagnosed with low level literacy skills or learning disabilities. �understanding can be determined on a regular basis followed by feedback from the teacher.

Traditional Methods of Teaching: One-to-one instruction �Limitations/disadvantages: �isolation of the learner from others who may have similar needs or concerns. �learners are deprived of the opportunity to share ideas, thoughts and feelings with others. �Learner might feel "put on the spot" because they are the only ones who are the object of teaching and may feel anxious. �learner might interpret question as a test of their knowledge and skills. �Costly.

Traditional Methods of Teaching: Demonstration and return demonstration �Demonstration. �a method by which the learner is shown by the teacher how to perform a particular skill. �prior to a demonstration, learners should be informed of the purpose of the procedure, the sequential steps to be involved, the equipment being used, and what they will be expected to do. �Return demonstration �a method by which the learner attempts to perform the skill with cues from the teacher as needed. �These two method are effective in teaching psychomotor domain skills.

Traditional Methods of Teaching: Demonstration and return demonstration �Advantages: �actively engage the learner through multiple stimulation of visual, auditory and tactile senses. �extended practice instills confidence for the learner to perform the skill competently.

Traditional Methods of Teaching: Demonstration and return demonstration �Limitation/disadvantages: �time-consuming—require plenty of time to be set aside for teaching as well as learning. �expensive—due to the need of keeping the size of the group small and the need for individual supervision during follow-up practice.

Non-Traditional Methods of Teaching Gaming �an instructional method requiring the learner to participate in a competitive activity with preset rules. �the goal of the game is for the learners to win a game by applying knowledge and rehearsing skills previously learned. �the teacher role is facilitator. �at the end of the game, the teacher should conduct a debriefing session focusing on educational content and evaluating the learning experience. Learner should be given a chance to discuss what they learned, ask questions, received feedback regarding the outcome of the game, and offers suggestion for improving the process.

Non-Traditional Methods of Teaching Gaming �Advantages �fun with a purpose. Its add a variety to the learning experience. �promotes retention of information by stimulating learner enthusiasm and increasing learner involvement. �it requires the learner to use problem solving and critical thinking strategies. �effective for improving cognitive functioning, enhance skills in psychomotor domain, and influence affective behavior through increased social interaction.

Non-Traditional Methods of Teaching Gaming �Limitations/Disadvantages: �can create a competitive environment that may be threatening to some learners. �the group size must be kept small for all members be able to participate. �the room must be more flexible than a traditional classroom. �noise level may be higher �requires more physical demanding than any other methods.

Non-Traditional Methods of Teaching Simulation �a method where by an artificial or hypothetical experience is created that engage the learner in an activity that reflects reallife conditions but without the risks taking consequences of the actual situation. �learners are rehearsing behaviors or roles that they will need to master and apply in real life.

Non-Traditional Methods of Teaching Simulation �Example: �A staff nurse is learning to respond to a chest trauma victim in an emergency room setting and is expected to gather an assessment rapidly and set up a chest tube drainage system with accuracy and speed. All these action will take place while the nurse is pretending to interact with other team members and a very frighten patients.

Non-Traditional Methods of Teaching Simulation �Advantages: �participant can try their problem solving, interactive and psychomotor skills. �clinical judgment and technical proficiency can be practiced in safe environment. �effective for teaching higher-level of cognitive domain, as well as promoting the attainment of psychomotor and affective skills. �Limitation/Disadvantages: �expensive �labor intensive.

Non-Traditional Methods of Teaching Role Playing �a method by which learner participates in an unrehearsed dramatization. They are asked to play assigned parts of a character as they think the character would act in reality. �it is different from simulation, because the learner in role- playing is not mastering a role in order to use it but rather to develop understanding of other people.

Non-Traditional Methods of Teaching Role Playing �Example: �Simulation: a diabetes patient in self management education program will need to practice behavior such as selecting foods in a restaurant menu and setting their insulin pumps for correct bolus of insulin because these are self management skills they need to master. �Role playing: the nurse attending an education program, may wear an insulin pump containing saline and select the appropriate foods to "see how it feels" to have to be aware of these issues rather than for the purpose of mastering the techniques.

Non-Traditional Methods of Teaching Role Playing �Advantages: �provides an opportunity for the learner to explore feelings and attitudes. �it has the potential to bridge the gap between understanding and feeling. �reduce the distance between clients and professionals. �Limitations/Disadvantages: �the participant may overly exaggerate the roles assigned to them, they become too dramatic and then the part loses its realism and credibility. �participants may become uncomfortable in their role and therefore are unable to develop the role sufficiently.

Non-Traditional Methods of Teaching Role-Modeling �Role-Modeling. the use of self as a role model is often overlooked as a method. Learning from role modeling is called identification from socialization theories that explain how people acquire new behaviors and social roles. Action speaks louder than voice.

Non-Traditional Methods of Teaching Self instructional activities (self-study) �a method used by a teacher to provide or design instructional activities that guide the learner in independently achieving the objectives of learning. �the teacher provide a self-study module that usually focused on one topic and the hallmark of this method is independent study. Modules come in form of workbooks, study guides, videotapes or computer programs.

Non-Traditional Methods of Teaching Self instructional activities (self-study) �Advantages: �effective for learning in the cognitive and psychomotor domain. �effective for introducing principles and step by step guidelines prior to demonstration of psychomotor skills. �learner has self pacing and active learning. �learner has a chance to review and reflect on information. �cost-effective and less time consuming.

Non-Traditional Methods of Teaching Self instructional activities (self-study) �Limitations/Disadvantages: �low literacy skills which can impede their ability to read or comprehend information as presented. �visual and hearing impairment �low levels of motivation �may also be boring when overused with the same population with no variation in the activity design.

Non-Traditional Methods of Teaching Computer assisted instruction �an individualized method of self study using the high technology of the computer to deliver an educational activity. It allows the learner to proceed at their own place with immediate and continuous feedback on their progress as they respond to the software program.

Non-Traditional Methods of Teaching Computer assisted instruction �Advantages: �actively involves the learner in the learning process. �instruction is individualized to meet the learners need. �learner can set the pace, spend as much time on a subject as needed for mastery, and will do so in a private nonjudgmental environment. �time efficient—it assist the learner in the achievement of educational objectives in about one third the time required by traditional methods. �gives opportunity for slow learners to repeat lessons as many times as necessary.

Non-Traditional Methods of Teaching Computer assisted instruction �Limitations/Disadvantages: �labor intensive if self composed �not a widespread skills among nurse educator �requires self-motivation—may not be effective for learners who require human interaction to learn best. �expensive

Non-Traditional Methods of Teaching Distance learning �a telecommunication approach to instruction using video technology to transmit live or taped messages directly from the instructor to the viewer. Teleconferencing allows for video and audio information to be sent via satellite or ground telephone line from one place to another.

Non-Traditional Methods of Teaching Distance learning �Advantages: �deliver information to a wide variety of people located at great distance from each other. �transmit information without the cost and time in traveling to meet face to face with the expert delivering the instruction. �inexpensive

Non-Traditional Methods of Teaching Distance learning � Limitations/Disadvantages: �teacher and learner are physically removed from each other. �it can become a lecture type, one way interaction session if no telephone hookup is available for interactive question and answer.

Evaluation of instructional methods Five major questions that will help to decide which method to choose 1. Does the method help the learners to achieve the stated objectives? 2. Is the learning activity accessible to the learners you have targeted? 3. Is the method efficient given the time, energy, and resources available in relation to the number of learners you are trying to reach? 4. To what extent does the method allow for active participation to accommodate the needs, abilities and style of the learner? � Evaluate how active learners want to be or are able to be in the process of gaining knowledge and skills. Active participation is a way to increase interest in learning and in retention of information. 5. Is the method cost-effective? � It is vital to examine the cost of educational programs to determine if similar outcomes can be achieved by using less costly methodologies.

Techniques to Enhance Effectiveness of Teaching: �Present information enthusiastically—try to vary the quality and pitch of voice, use a variety of gestures, and facial expressions, change position if necessary to make direct and frequent eye contact with everyone in the group, and demonstrate interest in the topic to attract and fascinate an audience. �Include humor—many creative teachers use humor as a technique to grab, arouse, and maintain the attention of the learner.

Techniques to Enhance Effectiveness of Teaching: �Deliver material dramatically—engage the learner emotionally by using surprise, controlled tension or ploys. �Use method that match the topic rather than the teacher's personality—use a teaching style appropriate for the subject matter, setting and the various styles of learners. �Choose problem solving activities—the teacher will need to orchestrate opportunities that challenge learners to critically analyze situation as well as support the learner in exploring possible alternative solutions.

Techniques to Enhance Effectiveness of Teaching: �Serve as a role model—role modeling is an effective way to facilitate learner. Teachers are seen as a credible role models when they are actively engaged in scholarly activities, experienced in the field, and have advanced credential to teach a complex skills. �Use anecdotes and examples—these are valuable in clarifying a topic under discussion, or helping someone better relate to an issue. Simple representation can assist the learner grasp complex idea.

Techniques to Enhance Effectiveness of Teaching: �Use technology—this will broaden and add variety to the opportunities of teaching and learning. Technology has the potential for making the teaching-learning process more convenient, accessible and stimulating. �Summarize important point—summarizing review key ideas to instill information in the mind and help the learner to see the parts of a whole and also reinforces retention of information.

Techniques to Enhance Effectiveness of Teaching: �Use repetition and pacing—a technique that strengthens learning. Repetition reinforces learning by aiding in the retention of information, it assist the learner in focusing on important points. The technique is especially important when presenting difficult material. �Elicit and give feedback—a strategy to give information to the learner as well as to receive information from the learner. Both the teacher and the learner need to seek information about the quality of their performance.

Techniques to Enhance Effectiveness of Teaching: �Give positive reinforcement—acknowledge ideas, actions, and opinions of learners by using words of praise or approval, such as "that's a good answer", "I agree with you", and "you have a very good point" or using a nonverbal expressions of acceptance such as smiling , will encourage learners to participate more readily or try harder to improve their performance. �Use questions—it helps to clarify or substantiate concepts, assess what the learner already knows about the topic, stimulate interest in a new subject, or evaluate the learner in mastery of the predetermined objectives.

Techniques to Enhance Effectiveness of Teaching: �Project an attitude of acceptance and sensitivity—exercise patience and sensitivity with respect to race, culture, and gender, this projects an acceptance of others, which servers to establish a rapport and opens up the avenues of communication for the sharing of ideas and concerns. The ease with which the teacher conduct themselves, the willingness to receive and answer questions, the simple courtesies extended, and the responsiveness demonstrated toward an audience set the tone for friendly, warm, and receptive atmosphere for learning.

Techniques to Enhance Effectiveness of Teaching: �Be organized and give direction—teachings do not happen by accident. They are the result of hours of skilled preparation, careful planning, and organization, which allow the learner to stay focused on the objectives. Instructional session should be relatively brief so as not to overload the learner with too much detail and extraneous content.

Instructional Materials are the resources and tools used as vehicle to help communicate the information. This is tangible substances and real objects that provide the audio and/or visual component necessary for learning. 115

Types of instructional materials 1. Written Materials 2. Demonstration Materials � displays � models 3. Audiovisual Materials � projected learning resources � audio learning resources � video learning resources � telecommunication learning resources � computer learning resources. 116

Choosing instructional materials �Learning can be made more enjoyable for both the learner and the teacher if the educators knows what instructional materials are available, as well as how to select and use them to enhance the teaching-learning experience. �Knowledge of the diversity of instructional tools and their appropriate use will enable the teacher to make education more interesting, challenging, and effective for all types of learners. 117

Variables to consider in choosing instructional materials 1. Characteristics of the learner—"know your audience" in order to choose media that best suit their needs. Consider the learner's perceptual abilities, reading ability, motivational level, developmental stage, and learning style. 2. Characteristics of the task—characteristics are defined by the predetermined behavioral objectives. The task to be accomplished depends on identification of learning domain and complexity of behavior required by the task. 3. Characteristics of the media—choose from a wide variety of media to enhance methods of instruction: print and non-print. Non-print includes the full range of audio-visual possibilities. 118

The three major components of instructional materials 1. Delivery system—the physical form of the materials and the hardware used to present the information. It is independent of the content of the message. The choice of the delivery system is influenced by the size of intended audience, pacing or flexibility needed for delivery, and the sensory aspect most suitable to the audience. Example: person, transparency, projector, video, computer. 2. Content—the actual information communicated to the learner, which might be on any topic. 3. Presentation—the variables that affect the way in which the content or message to be learned is delivered (Frantz , 1980). The form of the message occurs along a continuum from concrete (real thing) to abstract (symbols) 119

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