The document discusses Kurt Lewin's three-stage model of change known as the unfreezing-change-refreezing model. It explains each stage: unfreezing involves making people open to change, change is the process of adopting new behaviors or thoughts, and refreezing establishes the new habit. It also discusses the importance of effective communication between healthcare professionals and patients, and some barriers like language differences. Strategies to minimize disruptions include using a translator, speaking clearly, and checking for understanding.

1. DQ 2-1 responses 5
5. The Change Theory was a three-stage model of change
developed by Kurt Lewin. This model was also known as the
unfreezing-change-refreezing model that can be used by health
care professionals when making discussing treatment for
patients (Manchester, et al, 2014). The unfreezing process
involves making it possible for people to change their mind.
This can be done by helping them overcome a resistance or
introducing new information. It is a way to increase the driving
forces away from the current situation, such as encouraging a
patient to have a diagnostic heart catheter after they have had
several episodes of chest discomfort, but is afraid of going to
the hospital for a procedure. Change is when there is a change
of thought, behavior, or something that moves one from their
current or frozen situation. This can be described as the patient
agreeing to proceed with the heart catherization, getting on
appropriate medication, and following a healthier lifestyle. The
Refreezing is established after then change has happened and
there is a new habit. For example, after the patient has the heart
catheterization, he or she adopts a healthier lifestyle by being
compliant with medication and the physician’s treatment
recommendations, eating a heart-healthy diet, and exercising.
Communication is more than sending a message from one
person to another. Communication involves nonverbal
communication such as tone, body language, dialect,
paralanguage, proximity, touch, eye contact, gestures, posture,
and more. Nonverbal communication between a physician and
patient influences patient perception, such as patient
satisfaction (Montague, Chen, Xu, Chewning, & Barrett, 2013).
Verbal and nonverbal communication barriers such as
healthcare jargon, language barriers, emotional barriers,
differences in perception and view point, and physical
disabilities. Environmental barriers can also disrupt and distort
messages. To minimize disruptions and distortions in

2. communication, health care professionals should eliminate noise
distractions by taking the patient to a quiet room or closing the
door to the exam room or hospital room for privacy. One should
speak clearly and slowly, checking for understanding before
moving on to the next part of the message. Health care
professionals should use a medical certified translator when
there is a language barrier or hearing impairment. Reading the
patient’s body language can also suggest if the patient is
understanding and following along. Cell phones ringers should
be turned off to not interrupt the communication. Eye contact
demonstrates listening and understanding for both parties.
Touch can be clinical and social (Montague, Chen, Xu,
Chewning, & Barrett, 2013). A clinician must touch to the
patient to assess, diagnose, and treat. However, touching
through a handshake, hug, or pat on the back, can be social,
therapeutic, and healing. The important part of communication
is to make sure one’s message is received and understood. In a
clinical setting, this can be confirmed by asking the patient to
paraphrase the message. One method used by health care
professionals is the Teach-back Method (AHRQ, 2015). This
method is used to check the understanding by asking patients to
repeat the instruction they were given by using their own words.
This method has been shown to improve patient understanding,
adherence, and health literacy.
Maxia
References
Agency for Healthcare Research and Quality (AHRQ). (2015).
Use the teach-back method: Tool #5. Retrieved from
https://www.ahrq.gov/professionals/quality-patient-
safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-
tool5.html.
Manchester, J., Gray-Miceli, D. L., Metcalf, J. A., Paolini, C.
A., Napier, A. H., Coogle, C. L., & Owens, M. G. (2014).
Facilitating Lewin's change model with collaborative evaluation
in promoting evidence based practices of health
professionals. Evaluation and Program Planning, 4782-90.

3. doi:10.1016/j.evalprogplan.2014.08.007
Montague, E., Chen, P., Xu, J., Chewning, B., & Barrett B.
(2013). Nonverbal interpersonal interactions in clinical
encounters and patient perceptions of empathy. Journal of
Participatory Medicine. 5(33). Retrieved from
https://participatorymedicine.org/journal/evidence/research/201
3/08/14/nonverbal-interpersonal-interactions-in-clinical-
encounters-and-patient-perceptions-of-empathy.
DQ 2 responses
1
Much of what I will be discussing for my project is largely
based on qualitative research and how the interactions of
behaviors between and in a hospital departmental system causes
the dysfunction of policy. "Grounded theory as a methodology
has its roots in sociology, more specifically symbolic
interactionalism (a theoretical approach to understanding the
relationship between humans and society)" (Ellis, 2017). By
utilizing and understanding different qualitative methods in
research, the objective is to easily draw conclusions based on
those theories. Thus, the conundrum of proper policy
implementation in the OR for the best interests of patient safety
and organizational integrity.
ELLIS, P. (2017). Language of research (part 12) -- research
methodologies: grounded theory. Wounds UK , 13 (1), 102-
103.
2
The methodology that a researchers uses will depend on the
mostappropriate diverse method to answer the question they are
investigating. Keeping in mind, that the research question will
determine the choice of method. Two methods include empirical
data and conceptual date. Empirical data contains facts, a
collection of results to describe situations or to test theories

4. (EPPI-Centre, 2011). Conceptual research consist of developing
and arranging conceptual understandings (EEPI-Centre, 2011).
Ultimately, the researchers decide the research methodology on
the purpose of the research question and the type of results the
researches desires.
Reference
EPPI-Centre, Evidence Informed Policy and Practice in
Educationin Europe (2011). Choosing appropriate research
methodologies and methods. Retrieved from;
http://www.eippee.eu/cms/Default.aspx?tabid=3284
3
To determine the methodology that a researcher uses depends on
the approach and basic structure of the research. For example,
for a nurse researcher who chooses to use an integrative review
as a methodological approach has to use a five-stage approach
and these stages implemented can be systematically and
thorough (Hopia, Latvala & Liimatainen, 2016). With the
increasingly demand for evidence-based practices in the nursing
field, this is why “integrative review” is the methodology
nurses would use (Hopia, Latvala & Liimatainen, 2016).
Methodology not only provides the qualitative information of
the research but can address the relationships between the
philosophical assumptions on one hand and the nature of the
substantive research questions being addressed in the research
on the other hand (Green, 2015). By this information provided
about methodology, it is known to relate why a research is
based on a main question.
Green, C. J. (2015). Toward young children as active
researchers: A critical review of the methodologies and methods
in early childhood environmental education. The Journal Of
Environmental Education, 46(4), 207-229.
doi:10.1080/00958964.2015.1050345
Hopia, H., Latvala, E., & Liimatainen, L. (2016). Reviewing the
methodology of an integrative review. Scandinavian Journal Of

5. Caring Sciences, 30(4), 662-669. doi:10.1111/scs.12327
DQ 2-1 responses
1.
In health care effective communication is the key to the
wellbeing of patients. Communication between patient and
doctor, clinicians with doctors, front desk and patients, is
important to be able to deliver quality of care and for everyone
in the medical facilities to be in the same page. Transferring
information within the medical staff is essential to promote
effective care. When everyone in the office or hospital are in
the same page, everyone understands what is going and there is
no confusion, for when a patient asks question. No one is lost,
and the patient feels confident of their own care. However,
health care experiences barriers that disrupt and distort the
message. Barriers that can cause disruption and distort, are as
follows, lack of knowledge, lack of access to technology, lack
of support and social, cultural and organizational limitations.
Minimizing these barriers will help message to be fully
knowledgeable. Nothing is perfect, but things can be minimized
to less error possible.
To minimize disruptions and distortions in a message in a
medical organization, the message should be done in a
particular way. Messages can change from one person to
another, so it is important to communicate as exact as possible.
Steps to reduce distortion include, limit amount of information
included in the message, avoid using abstract words, or slang
words, and monitor the links in the communication chain
(Kautilya Society). Messages that are to informative are easier
to lose information or misinterpreted. The best way to minimize
disruption and distortion is direct oral conversation with the
main person. The content of the message is direct and straight
forward. As far as culture barriers, the meaning to words,

6. symbols, gestures, and behavior differs per culture (Essays,
2015). To minimize misunderstanding providers and clinicians
can learn about different cultures and their ways of
communication.
Reference
Kautilya Society, Guidelines on How to minimize message
distortion. Retrieved
from; http://www.kautilyasociety.com/tvph/communication_skil
l/guidelines_on_how_to_minimize_me.htm
Essays, UK. (November 2013). Resolving And Defining The
Barriers To Communication English Language Essay. Retrieved
from https://www.ukessays.com/essays/english-
language/resolving-and-defining-the-barriers-to-
communication-english-language-essay.php?cref=1
2.
For my project, I will be utilizing clinical research primarily in
the analysis of my concdrn. The fact that there are so many
different types of distractions and disruptions, but the ones that
make the most impact is generally confusion in expressing the
objective of the research methods. There are barriers that exist
in the research process and those can be seen in many areas of
clinical consideration. "Nurses generally feel there are many
barriers, with primary barriers being lack of time, lack of
relevant skills, poor team-working and several aspects of
nursing ‘culture’ (ritualistic care, no authority and no
incentives)" (Sitzia, 2002). These issues along with
communication, interpretive bias, variability between
researchers can lead to inconsistent and erroneous evaluation of
the data and literature compiled. With sufficient aggregate
conclusions found within significant and valid research, we will
begin to understand the implications of the data we evaluate and
thus find a more conclusive anser to the posed issue.
Sitzia, J., (2002)., Barriers to research utilisation: the clinical
setting and nurses themselves Intensive and Critical Care
Nursing., Volume 18, Issue 4,., Pages 230-243
3.

7. The way we perceive messages depends on the way we were
taught to understand. An example I can think of is about me.
Growing up my parents spoke to me in English only. The thing
is English is a second language to my parents. So, words that
sound the same but have different meaning, they would use and
would get the whole conversation mislead or misunderstood. I
consider English as my primary language since that was the
only language spoken to me, but I was wrong, my teacher told
me since there was another language spoken in the house even
though not directly to me, English is a second language. I did
have a hard time learning the English language in school
because of the kind of English spoken to me at home. So, to
minimize any disruptions or barriers while communicating a
message, the sender should try to get to the same level of the
reader and use easy words that a fifth grader would understand.
Another way is to describe or characterize the message to a
point that the reader fully understands the message. “Theories
of change link outcomes and activities to explain how and why
the wanted change is to come about” (Lecture 2, 2009).
According to Hemmerich, Van Voorhis and Willey, even when
people do not change theories, issues valid to the proof and
changes to the theories decrease their confidence in their
current theory and move them incorrectly closer to theory
change.
Lecture 2. (2009). HLT-490V: Professional Capstone Project.
Phoenix, AZ: Grand Canyon University.
· Q. Compare and contrast 2 learning theories that are
applicable to your field of study/work explaining how and why
the learning theories are subjectable to your communication
skills.
· http://www.emtech.net/learning_theories.htm
I don’t have enough post to comment. Are you able to comment
these post based on above topic?

8. 4. Two learning theories that are subjectable to communication
skills in my work field are Conversation Theory by Gordon Pask
and Adult Learning by K.P. Cross. Both theories concentrate on
how individuals learn and grasp information. In contrast
learning in adults is different to a younger person. In the theory
of Adult learning, the transmission of communication differs on
the way information is spoken to the elderly. The model of
Characteristics of Adults as Learners (CAL), integrates
theoretical frameworks such as asandragogy, and experimental
learning, and lifespan psychology (Culatta, 2015). Learning
depends on two variables personal (e.g., aging, life phases, and
developmental stages) and situational characteristics. Adult
learning should be accommodated to their needs and learning
capacities. As for Conversation Theory, focuses on learning
through conversations. Conversations are in different levels,
including, natural language, object language, and metalanguages
(Culatta, 2015). In Conversation theory, the “teach back”
method helps a person teach another person what they have
learn, making the person pay attention and grasp the
information.
Both theories are subject to communication in my work
environment because our patient population differs in ages, but
the majority are adults. Communicating and educating our
patients on cancer diagnoses, treatments and side effects is
important for patients to fully understand. Having a variety of
ages learning is different among every patient, therefore
learning different ways to talk to patients with be beneficial to
their learning. In fact, if the patients learn the information, it
means that our education is effective.
Reference
Richard Culatta, Conversation Theory (Gordon Pask),
Instructional Design, 2015. Retrieved
from;http://www.instructionaldesign.org/theories/conversation-
theory.html
Richard Culatta, Adult Learning (K.P. Cross) Instructional
Design, 2015. Retrieved from;

9. http://www.instructionaldesign.org/theories/adult-learning.html
5. Cooperative Learning and Constructivism are the 2 learning
theories that are applicable to my field of work and have been
through all the different departments that I have worked in. It
is very important for everyone to be cooperative while
communicating because a good team that can work well together
by providing cooperation will succeed in all of their work
projects. Using cooperative learning has resulted in improved
academic achievement, improved behavior and attendance,
increased self-confidence and motivation (Balkcom, 1992).
Constructivism is very important because if there is no
constructive work, things will fail and be out of place. Total
chaos in simple terms. I trully believe a team is built with
constructivism and based on cooperative learning so that the
project the team is given to complete will be completed
successfully this is why these 2 learning theories are
subjectable to my communication skills.
Balkcom, S. (1992). Cooperative Learning. OR 92-3054.
Retrieved from
https://www2.ed.gov/pubs/OR/ConsumerGuides/cooplear.html