1. The document discusses key topics in health care education including the historical foundations of nursing education, trends affecting health care systems, and the purposes and goals of patient and staff education. 2. Barriers to education refer to factors that impede a nurse's ability to provide education while obstacles to learning refer to factors that negatively impact a learner's ability to process information. 3. The document discusses Luker and Caress as writing the classic article "Rethinking Patient Education" which argued that not all nurses should be responsible for patient teaching due to educational background differences.

1. Overview of
Education in
Health Care

2. Historical Foundations for the Teaching Role of Nurses
Social, Economic, and Political Trends Affecting Health
Care
Purpose, Benefits, and Goals of Patient and staff
Education
The Education Process Defined
Role of the Nurse as Educator
Barriers to Education and Obstacle to Learning
Barriers to Education
Obstacle to Learning
Perspectives on Research in Patient and Staff Education
Questions to be Asked Regarding the Delivery of
Educational Services
1.
2.
3.
4.
5.
6.
7.
8.
Charpter Highlights

3. *education process
*teaching
*instruction
*learning
*patient education
*staff education
*barriers to education
*obstacle to learning
KEY TERMS

4. Discuss the evolution of the teaching role of nurses.
Recognize trends affecting the healthcare system in
general and nursing pratice in particular.
Identify the purpose, benefits, and goals of patient and
staff education.
Compare and contrast the education process to the
nursing process.
Define the terms teaching and learning.
Identify reasons why patient and staff education is an
important duty for professional nurses.
Discuss barriers to education and obstacles to learning.
Formulate questions that nurses in the role of educator
should ask about the teaching-learning process.
1.
2.
3.
4.
5.
6.
7.
8.
OBJECTIVES

5. What is Education in
Health care today?

6. today—both patient
education and nursing
staff/student
education is a topic of
utmost interest in
every
setting in which
nurses practice.

7. The current trends in health care are making it
imperative that patients and their families be
prepared to assume responsibility for self-care
management.
The focus is on outcomes—whether it
be that the patient and his or her
family have learned essential
knowledge and skills for independent
care.

8. Another purpose of this chapter is to offer a
perspective on the current trends in health
care making patient teaching a highly visible
and required function of nursing care delivery.
One purpose of this chapter is to shed light on the historical
evolution of teaching as part of the professional nurse’s
role.

9. HISTORICAL
FOUNDATIONS
FOR THE
TEACHING ROLE
OF NURSES
#1.

10. Topic or Idea
Patient education has long been considered a major component
in the repertoire of standard care-giving by the nurse.
mid-1800s, nursing was first acknowledged as a unique
discipline, the responsibility for teaching has been recognized
as an important healthcare initiative assumed by nurses.
Florence Nightingale, the founder of modern nursing, was the
ultimate educator.
1900s, public health nurses in this country clearly understood
the significance of education in the prevention of disease and
in the maintenance of health (Chachkes & Christ, 1996).
For decades, then, patient teaching has been recognized as an
independent nursing function.

11. 1918 - the National League of Nursing Education (NLNE)
in the United States [now the National League for
Nursing (NLN)] observed the importance of health
teaching as a function within the scope of nursing
practice.
1950 - the NLNE had identified course content dealing
with teaching skills, developmental and educational
psychology, and principles of the educational process of
teaching and learning as areas in the curriculum
common to all nursing schools (Redman, 1993).
1993 - In recognition of the importance of patient
education by nurses, the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO)
delineated nursing standards for patient education

12. JCAHO - expanded its expectations to include an
interdisciplinary team approach in the provision of patient
education as well as evidence that patients and their
significant others understand what they have been taught.
1970s - In addition, the Patient’s Bill of Rights, first
developed in the 1970s by the American Hospital
Association and adopted by hospitals nationwide, has
established the rights of patients to receive complete and
current information concerning diagnosis, treatment, and
prognosis in terms they can reasonably be expected to
understand.

13. 1995 - the Pew Health
Professions Com mission,
influenced by the dramatic
changes currently
surrounding health care,
published a broad set of
competencies that it believes
will mark the success of the
health professions in the
twenty-first century.

14. Provide clients with education and coun seling on
ethical issues
Expand public access to effective care
Provide for prevention of illness and promo tion of
healthy lifestyles for all Americans
Commission (1998) released a fourth report as a follow-up
on health professional practice in the new millennium.
• Provide clinically competent and coordi nated care to the
public
• Involve patients and their families in the decision-making
process regarding health interventions
• Ensure cost-effective and appropriate care for the
consumer

15. the provider teaching role has
evolved from what once was a
disease-oriented approach to a more
prevention-oriented approach.
1980s - greater recognition has been
given to client education as a
healthcare activity.
patient
education

16. Presently, the
demand for nurses in
the role of educators
of patients, their
families, and the
general public is
rapidly accelerating.
- the role of today’s educator is
one of “training the trainer”
preparing nursing staff through
continuing education, in-service
programs, and staff development to
maintain and improve their clinical
skills and teaching abilities.
(DOPE)-disease-
oriented patient
education
(POPE) - prevention-
oriented patient
education
(HOPE) health-
oriented patient
education
Grueninger (1995)
1.

17. key to the
success
In addition
for nurses to
teach other
nurses. We are the
primary educators
of our fellow
colleagues and
other healthcare
staff personnel.
the demand for
educators of
nursing students
is at an all-time
high.

18. SOCIAL,
ECONOMIC, AND
POLITICAL
TRENDS
AFFECTING
HEALTH CARE
2.

19. In addition to the professional and
legal standards put forth by
various organizations and agencies,
there has arisen an increasing
emphasis on nurses’ potential role
in teaching activities as a result
of social, economic, and political
trends nationwide affecting the
public's health.

20. 01
02
"The federal government", through
health care reform initiatives,
has established national health
goals and objectives for the
future. Healthy People 2010:
National Promotion and Disease
Prevention Objectives (U.S.
Department of Health and Human
Services, 2000)
"growth of managed care", the
shifts in payer coverage, and
the issue of reimbursement
15
Significant
forces affecting
nursing practice
in particular and
the healthcare
system in general

21. 03
04
05
"Health providers"
are beginning to
recognize the
economic and social
values
"Political emphasis"
is on productivity,
competitiveness in the
marketplace, and cost
containment measures
to restrain health
service expenses.
The "healthcare reform
movement" is opening
up new avenues for
expansion of
preventive

22. There is concern on the
part of healthcare
professionals regarding the
legal pressures associated
with malpractice and
disciplinary action for
incompetency. Demographic trends—
namely, the aging of
the population—are
requiring an emphasis
to be placed on self-
reliance and
maintenance of a
healthy status over an
extended lifespan.
06
07
08
09
The interest that continues
to be exhibited by nurses in
defining their own role,
body of knowledge, scope of
practice, and professional
expertise has focused on
patient education as central
to the practice of nursing.
Consumers are demanding
increased knowledge and
skills about how to
care for themselves and
how to prevent disease.

23. 10 11
12
Among the major causes of
morbidity and mortality are
those diseases now
recognized as being
lifestyle-related and
preventable through
educational interventions.
The proportionate
increase in the
incidence of chronic and
incurable conditions
necessitates that
individuals and families
become informed
participants to manage
their own illnesses.
Advanced technology is
increasing the complexity of
care and treatment as well as
diverting large numbers of
patients from inpatient
healthcare settings to
community-based settings.

24. 13
14
15
Earlier hospital
discharge is forcing
patients and their
families to be more
self reliant while
managing their own
illnesses.
There is a belief on the part
of nurses and other healthcare
providers, which is supported
by research, that patient
education improves compliance
and, hence, health and well-
being.
There is an increased
proliferation in the number
of self-help groups
established to support
clients in meeting their
physical and psychosocial
needs

25. Nurses recognize the need to
develop their expertise in
teaching to keep pace with the
demands of patient and staff
education. They are the
healthcare providers who have
the most continuous contact
with patients and families, are
usually the most accessible
source of information for the
consumer, and are the most
highly trusted of all health
professionals.

26. PURPOSE,
BENEFITS, AND
GOALS OF
PATIENT AND
STAFF EDUCATION
#3.

27. Current and continuously improving
patient and staff education programs are
an integral part of today’s system of
healthcare delivery to the public.

28. 01
02
03
04
05
Increase consumer
satisfaction
The benefits of effective
patient education are
many. Patient education
has demonstrated its
potential to:
06
07
08
Improve quality of
life
Ensure continuity of
care
Decrease patient
anxiety
Effectively reduce the
incidence of
complications of illness
Promote adherence to
health treatment plans
Maximize independence in
the performance of
activities of daily living
Energize and empower
consumers to become
actively involved in the
planning of their care

29. Numerous studies have
documented the fact that
informed patients are more
likely to comply with medical
treatment plans and find
innovative ways to cope with
illness.
OUR PRIMARY AIMS, THEN, AS EDUCATORS
SHOULD BE TO NOURISH CLIENTS AS WELL AS
MENTOR STAFF.

30. THE EDUCATION
PROCESS
DEFINED

31. The education process - is a
systematic, sequential, planned
course of action consisting of two
major interdependent operations,
teaching and learning.
*always been compared to the
nursing process
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32. Teaching Instruction
- is a deliberate
intervention that
involves the
planning and
implementation of
instructional
activities and
experiences to meet
intended learner
outcomes according
to a teaching plan.
- a term
often used
interchangea
bly with
teaching, is
one aspect
of teaching.

34. Learning
is defined as a change in behavior
(knowledge, skills, and attitudes)
that can occur at any time or in
any place as a result of exposure
to environmental stimuli.

35. Patient
education
is a process of assisting people
to learn health-related
behaviors (knowledge, skills,
attitudes, and values) so that
they can incorporate those
behaviors into everyday life.

36. Staff
education
by contrast, is the
process of influencing the
behavior of nurses
by producing changes in
their knowledge, attitudes,
values, and skills.

37. A useful paradigm to
assist nurses to
organize and carry
out the education
process
is the ASSURE
01
02
03
04
05
05
Analyze learner
State objectives
Select instructional
methods and tools
Use teaching materials
Require learner
performance
Evaluate/revise the teaching
and learning process.

38. ROLE OF
THE NURSE
AS
EDUCATOR
#5.

39. For many years, organizations
governing and influencing nurses
have encouraged and sup- ported
the belief that nurses should play
a major role in health education.

40. in particular, have
challenged the wisdom of
involving all nurses in
patient education as an
unrealistic and
undesirable goal of the
profession.
Luker and
Caress (1989),

41. it is unreasonable to expect every nurse to take
responsibility for teaching patients when the
majority of nursing practitioners have had only
a basic nursing education background from
diploma or associate’s degree–level programs.
“Rethinking Patient
Education,”

42. They noted that patient
teaching
“implies a didactic information
giving
approach,” whereas patient
education
“implies something more
comprehensive, for
which specialist skills are
required”

43. The role of educator is not primarily to
teach, but to promote learning and
provide for an environment conducive to
learning to create the teachable moment
rather than just waiting for it to happen
(Wagner & Ash, 1998).
the role of the nurse as teacher of
patients and families, nursing staff,
and students certainly should stem
from a partnership philosophy.

44. BARRIERS TO
EDUCATION AND
OBSTACLES TO
LEARNING
#6.

45. are those factors
impeding the nurse’s
ability to deliver
educational services.
Barriers to education

46. are those factors
that negatively
affect the ability of
the learner to
attend to and
process information.
Obstacles to learning

47. Barriers
to
Education

48. Numerous authors have addressed
the major
barriers interfering with the
ability of nurses
to carry out their roles as
educators
The following are the key
organizational, environmental,
educational,and clientele factors that
serve as impediments to educating
others:

49. Lack of time, Very ill
patients, Early discharge,
Finding time and Discharge
planning
Many nurses and other
healthcare personnel
are traditionally ill
prepared to teach.
Many nurses admit that
they do not feel
competent or confident
with regard to their
teaching skills.
Personal
characteristics of the
nurse educator play an
important role in
determining the outcome
of a teaching–learning
interaction.
low priority was often
assigned to patient and
staff education by
administration and
supervisory personnel.
01
02
03
04

50. The lack of space and
privacy in the various
Noise,frequent
interferences,
environmental settings.
An absence of third-party
reimbursement to support
patient education
programs relegates
teaching and learning to
less than high priority
status.
Some nurses and physicians
question whether patient
education is effective as a
means to improve health
outcomes.
There are a multitude of
healthcare providers
covering much of the
same content, but not
necessarily with
consistency.
The type of documentation system
used by healthcare agencies has an
effect on the quality and quantity
of patient teaching recorded.
05
06
07
08
09

51. Obstacles
to
Learning

52. The following are some of the
major obstacles interfering
with a learner’s ability to
attend to and process
information
(Glanville, 2000; Lipetz et
al., 1990; Gilroth,
1990; Seley, 1994):

53. The stress of acute and
chronic illness, anxiety,
sensory deficits, and low
literacy in patients are
just a few problems that
can diminish learner
motivation and interfere
with the process of
learning.
The negative influence of
the hospital environment
itself, resulting in loss
of control,lack of
privacy, and social
isolation,
Lack of time to learn due
to rapid patient discharge
Personal characteristics
of the learner have
major effects on the
degree
The extent of behavioral
changes needed, both in
number and in
complexity,
01
02
03
04
05

54. 06
02
03
Lack of support and ongoing
positive reinforcement from
the nurse and significant
others serves to block the
potential for learning.
Denial of learning needs,
resentment of authority, and
lack of willingness
The inconvenience,
complexity, inaccessibility,
fragmentation, and
dehumanization of the
healthcare system

55. PERSPECTIVES
ON RESEARCH
IN PATIENT
AND STAFF
EDUCATION
#7.

58. QUESTIONS TO
BE ASKED
REGARDING THE
DELIVERY OF
EDUCATIONAL
SERVICES

59. In examining the elements of the
education process and the role of the
nurse as educator, many questions
can be posed with respect to the
principles of teaching and learning.
01
How can members of the
healthcare team work
together more effectively to
coordinate educational
efforts?
02
What are the ethical, legal,
and economic issues
involved in patient and
staff education?
03
Which theories and
principles support the
education process?
04
How are teaching and
learning best evaluated?

60. Thank You!
For Listening

61. Question #1
Question #2
Question #3
What are the topics of Health Education?”
How are barriers to education different from obstacles to learning?
Name the two person who write the classic article, “Rethinking Patient
Education,”
QUESTION
Question #4
Question #5
What is PEW Commission?
What is meant by the terms teachable moment and training the trainer?

62. ANSWER KEY
Answer #1
Answer #2
Answer #3
Educational and community-based programs encourage and enhance
health and wellness by educating communities on topics such as: Chronic
diseases. Injury and violence prevention and Mental illness/behavioral
health.
Luker and Caress’s
Barriers education differ from obstacle learning is that "Barriers education
are those factor's impeding the nurse's ability to deliver educational services
while obstacle learning are those factors that negatively affect the ability
of the learner to attend to and process information.

63. ANSWER KEY
Answer #4
Answer #5
Influenced by the dramatic changes currently surrounding health care,
published a broad set of competencies that it believes will mark the success
of the health professions in the twenty-first century.
The point in time when the learner is most receptive to a teaching situation; it
can occur at any time that a patient, family member, staff member, or nursing
student has a question or needs information while training the trainer
preparing nursing staff through continuing education, in-service programs, and
staff development to maintain and improve their clinical skills and teaching
abilities

64. Thank You!
once again