Educating Patients: Understanding Barriers,
Learning Styles, and Teaching Techniques
Linda Beagley, MS, BSN, RN, CPAN
Health care delivery and education has become a challenge for providers.
Linda Beagley, M
cator, Swedish Cov
Conflict of intere
Address corresp
nant Hospital, 51
e-mail address: lbe
� 2011 by Ame
1089-9472/$36.
doi:10.1016/j.jo
Journal of PeriAnesth
Nurses and other professionals are challenged daily to assure that the
patient has the necessary information to make informed decisions.
Patients and their families are given a multitude of information about
their health and commonly must make important decisions from these
facts. Obstacles that prevent easy delivery of health care information
include literacy, culture, language, and physiological barriers. It is up
to the nurse to assess and evaluate the patient’s learning needs and read-
iness to learn because everyone learns differently. This article will
examine how each of these barriers impact care delivery along with
teaching and learning strategies will be examined.
Keywords: patient education, barriers, culture, literacy, perianesthesia
nursing.
� 2011 by American Society of PeriAnesthesia Nurses
EDUCATING PATIENTS HAS become a challenge
for health care providers because the patient
length of stay has decreased and the need to deliver
complex information has increased. A new version
of the melting pot society requires special efforts
by health care professionals to ensure that the pa-
tient understands the information given to him or
her. Barriers that inhibit patient education are liter-
acy, language, culture, and physiological obstacles.
Assessing and evaluating the learning needs of
the patient are essential before planning and im-
plementation of an educational plan. Presenting
a well-formulated plan will increase the likelihood
of a successful recovery for the patient. In this
article, barriers will be dissected and strategies
examined to determine what will best suit the edu-
cational needs of the patient.
S, BSN, RN, CPAN, is a PACU Clinical Edu-
enant Hospital, Chicago, IL.
st: None to report.
ondence to Linda Beagley, Swedish Cove-
40 N. California Ave, Chicago, IL 60625;
[email protected]
rican Society of PeriAnesthesia Nurses
00
pan.2011.06.002
esia Nursing, Vol 26, No 5 (October), 2011: pp 331-337
Adult Learning
To effectively educate patients, health care pro-
viders must have an understanding of the princi-
ples of adult learning. Malcolm Knowles, who
began to study adult learners in the 1960s, is
known as the father of adult learning principles be-
cause of his extensive writing on adult education.
The term andragogy, the art and science of teach-
ing adults, is synonymous with that of Knowles.
He deduced that adults learn differently than chil-
dren. His studies determined five assumptions on
learning: self-concept, experience, readiness to
learn, orientation to learning, and motivation to
learn.
1
Acco.
Health literacy is the most important factor in getting the proper health information and health services. Health literacy significantly affects healthcare accessibility, availability, affordability and eventually cost. Health literacy makes it possible for the people to actively participate in the healthcare decision making process.
Senior Citizens need to have comprehensive medical evaluations that are readily available to emergency providers. Electronic Medical Recording is ideal for having much needed information at the proper person's finger tips. The hesitancy of primary care physicians to employ EMR/EHR systems places a heavy burden on emergency departments in the United States. Senior citizens often have special needs that are not readily known by first responders and in a crisis situations, the care provided is based on standard of care and not special needs. Innovative alternatives to the current data taking, storage and retrieval process.
Case studyTJ, a 32-year-old pregnant lesbian, is being seen for .docxtroutmanboris
Case study
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over-the-counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
May 2012, Alice Randall wrote an article for
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
Consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering pertinent information?
Post
a 3-4 page explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional appr.
Health literacy is the most important factor in getting the proper health information and health services. Health literacy significantly affects healthcare accessibility, availability, affordability and eventually cost. Health literacy makes it possible for the people to actively participate in the healthcare decision making process.
Senior Citizens need to have comprehensive medical evaluations that are readily available to emergency providers. Electronic Medical Recording is ideal for having much needed information at the proper person's finger tips. The hesitancy of primary care physicians to employ EMR/EHR systems places a heavy burden on emergency departments in the United States. Senior citizens often have special needs that are not readily known by first responders and in a crisis situations, the care provided is based on standard of care and not special needs. Innovative alternatives to the current data taking, storage and retrieval process.
Case studyTJ, a 32-year-old pregnant lesbian, is being seen for .docxtroutmanboris
Case study
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over-the-counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
May 2012, Alice Randall wrote an article for
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
Consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering pertinent information?
Post
a 3-4 page explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional appr.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Low Health Literacy in the Older Adult: Identification & Intervention power p...Jeanne Baus
Low Health Literacy in Older Adults is a common challenge for home health care nurses. This powerpoint addresses how to identify low health literacy levels and how to effectively meet the patient needs to improve health education goals and outcomes.
Patients and their families are given a multitude of information about their health and commonly must make important decisions from these facts. Obstacles that prevent easy delivery of health care information include literacy, culture, language, and physiological barriers. It is up to the nurse to assess and evaluate the patient's learning needs and readiness to learn because everyone learns differently.
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
YolReview the Healthy People 2020 objectives for the older a.docxherminaprocter
Yol
Review the Healthy People 2020 objectives for the older adult. Of the objectives listed for the older adult, which do you feel is most important? Be sure to include examples and references to support your response.
Objective: Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions
(Healthy People 2020).
Chronic conditions may be difficult to manage based on the complexities of a disease. Additionally, managing one or more chronic conditions may be time consuming. Time consuming tasks may take the form of monitoring (e.g. checking blood glucose), keeping a diary, scheduling appointments, sorting and taking medications, exercising, meal planning, etc.. The Agency for Healthcare Research and Quality (2015) suggests the burden of these tasks significantly impact how patients manage their chronic conditions, and that patients often find it difficult to complete all these tasks in order to manage their condition effectively. Personally, I see examples of this every day at the hospital: Patients are not confident in their self-management ability and are therefore unable to demonstrate skill or awareness in regards to their condition. Despite receiving adequate medical attention from outstanding multidisciplinary teams, patients continue to show little interest in self-management, ultimately resulting in an overwhelming number of older adults who lack the confidence to manage one or more chronic conditions (Bodenheimer, 2005). Healthcare providers are being forced to seek new and innovative ways to connect with patients and reinforce educational material in order to give patients the confidence and skill to manage their care. I believe this objective to be most important because self-management is clinically proven to result in better outcomes. It is proven that support for patients and caregivers improve confidence in managing conditions. Recently, my hospital has added to its emphasis on education and follow up... Simply providing information to patients is not enough to build confidence, skill, nor the knowledge to manage their health. Therefore, nursing must collaborate to reinforce behaviors and promote better health outcomes in patients.
There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.
Based on recent events that have transpired in the news, one might acknowledge that refugees and immigrants are a vulnerable population... many of whom are struggling with chronic illness, and undeniably experiencing challenges related to our healthcare delivery system. Several barriers exist for this group, including language and technology barriers, expectations of medical care, cultural differences, as well as unique ...
This public health presentation educates the community regarding Latino health and the need for more collaborate healthcare services to meet the demand.
1Health Care DisparityBlack AmericansHispanicsLatinos.docxfelicidaddinwoodie
1
Health Care Disparity
Black Americans
Hispanics/Latinos
Demographics
45.7 million, which is 14.3% of USA population.
15% of the USA population
Cultural Norms
Strong kinship bonds, strong work orientation, strong religious orientation, take care of their own, seniors are highly respected, don’t like to admit they need help, poverty impacts education, self-esteem, quality of life and life style across.
Strong family ties, strong church and community orientation, male dominance, age dominance, negative view on asking for help, take care of their own majority are roman catholic, distrust of government, modesty is important and very proud of heritage
Religious and Spiritual Beliefs
Have strong religious affiliation with Christian denominations and also Islam.
Have strong belief in the spirit world. Majority are roman CatholicsS
Primary Insurance Coverage
Most of them are not insured, but the affordable care act provision target at improving provisions that will highly improve their lives.
Six in ten Hispanic adults in USA lack health insurance.
Education
17% have attained bachelor’s degree
11% have attained bachelor’s degree
Medical Conditions
They reside at disadvantaged neighborhoods with increased risks for health disparities. Obesity in children is enormous
More than a quarter of its population lack usual health care provider. Hispanic adults have a low prevalence for many chronic diseases and a high prevalence for diabetes.
Outreach
Foundation of African American outreach program to provide assistance to Africa-Americans
Action plan to reduce racial and ethnic health disparities
Introduction
The health of a population is influenced by both its social and its economic circumstances and health care services it receives. The health care services provided to Hispanics and black in United States of America is low. Throughout the years we have seen advancements in the health care quality received by ethnic minorities groups. But there is still a large gap when comparing minorities with their white counterparts (Vicini, 2015). This has affected the two groups which have low income families and experience poor quality care. Hispanic and blacks are less likely to have a high school education. Disparities in quality of care are common among the blacks and Hispanics in USA. For instance adults of 65 years and above receive worse care than adults with 18-44 years. Poor people have worse access to care than the high income people (Lee et al., 2003).
Healthcare Disparities between the Blacks and the Latinos in USA
The healthcare insurance status for the blacks and Latinos is low and as a result it forms barriers to access to quality health care utilization. Language barriers in health care are associated with decrease in quality of care, safety, patient and clinical satisfaction and contribute to health disparities even among people with insurance. Statistics have shown when comparing blacks and Latinos to their whi ...
Shane Desautels is the director of NewWays learning. He has worked in the field of social services for over 30 years. As a literacy consultant to the South Side Health and Vitality Studies, he has provided expertise in the areas of technology literacy, adult and youth learning, empowerment strategies, and communication with traditionally marginalized groups.
Elementary CurriculaBoth articles highlight the fact that middle.docxtoltonkendal
Elementary Curricula
Both articles highlight the fact that middle-class students seem to benefit more from summer reading programs than their lower-SES peers. While we would hope that summer reading programs would have the same positive impact on all students, this information did not totally surprise me. Differences in funding, materials, and ability to recruit enough high-quality teachers for summer programs could be more difficult in lower-socioeconomic areas. In addition, the articles did not dive into other factors in the students’ lives that may be contributing to their performance such as attendance, how well-rested they are, trauma they have experiences that impacts their ability to focus during instruction, and the impact of being taught by a teacher who the students may not know or have a relationship with. Additionally, there could be a mismatch between the instructional practices and the specific needs of the students. Even though summer reading programs are only for a short time, I would challenge teachers to put energy into getting to know the students and building trust with them. This is a key foundation that is needed for learning to take place.
In challenging teachers during summer program and the regular school year to ”break out of the mold” to create better outcomes for students classified with low SES, in addition to building relationships with students, I would encourage them to build connections with their families. This may involve thinking outside the box and leaving their comfort zone. It could entail holding a parent-teacher conference off campus, closer to their home or in their community. It could also include providing resources and instructional videos to parents so they can help support their children at home. There are many parents who want to support their children academically, but they do not know how and may be uncomfortable asking the teacher for assistance. In addition, I would urge teachers to capitalize on the strengths and interests of their students to engage them in learning activities and provide them with opportunities to shine. We do not have to, and should not, be satisfied with the idea that low SES students will automatically not be able to perform. These students are capable of learning and growth just as much as any other student. I think data from test scores that demonstrate a gap between the performance of students classified as economically disadvantaged and not economically disadvantaged has led some people to hold the belief that students classified as low SES will not perform well. I think the way that school “report card” grades are published also perpetuates this belief, as it shows the test scores, but does not provide an explanation of or include any solutions for the many larger societal factors that contribute to those scores including high teacher turn over, lack of resources, child trauma, lack of sleep, lack of nutrition, crime & safety, and education level of parents.
It w.
Elementary Statistics (MATH220)
Assignment:
Statistical Project & Presentation
Purpose:
The purpose of this project is to supplement lecture material by having the students to do a case study on collecting, analyzing, and interpreting data.
***The best way to understand something is to experience it for yourself.
Guideline for Analyzing Data and Writing a Report
Below is a general outline of the topics that should be included in your report.
1.
Introduction.
State the topic of your study.
2.
Define Population.
Define the population that you intend for your study to represent.
3.
Define Variable.
Define clearly the variable that you obtained during your data collection; this should include information on how the variable is measured and what possible values this variable has.
4.
Data Collection.
Describe your data collection process, including your data source, your sampling strategy, and what steps you took to avoid bias.
5.
Study Design.
Describe the procedures you followed to analyze your data.
6.
Results: Descriptive Statistics.
Give the relevant descriptive statistics for the sample you collected.
7.
Results: Statistical Analysis.
Describe the results of your statistical analysis.
8.
Findings.
Interpret the results of your analysis in the context of your original research question. Was your hypothesis supported by your statistical analyses? Explain.
9.
Discussion.
What conclusions, if any, do you believe you can draw as a result of your study? If the results were not what you expected, what factors might explain your results? What did you learn from the project about the population you studied? What did you learn about the research variable? What did you learn about the specific statistical test you conducted?
.
More Related Content
Similar to Educating Patients Understanding Barriers,Learning Styles, .docx
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Low Health Literacy in the Older Adult: Identification & Intervention power p...Jeanne Baus
Low Health Literacy in Older Adults is a common challenge for home health care nurses. This powerpoint addresses how to identify low health literacy levels and how to effectively meet the patient needs to improve health education goals and outcomes.
Patients and their families are given a multitude of information about their health and commonly must make important decisions from these facts. Obstacles that prevent easy delivery of health care information include literacy, culture, language, and physiological barriers. It is up to the nurse to assess and evaluate the patient's learning needs and readiness to learn because everyone learns differently.
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
: https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
YolReview the Healthy People 2020 objectives for the older a.docxherminaprocter
Yol
Review the Healthy People 2020 objectives for the older adult. Of the objectives listed for the older adult, which do you feel is most important? Be sure to include examples and references to support your response.
Objective: Increase the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions
(Healthy People 2020).
Chronic conditions may be difficult to manage based on the complexities of a disease. Additionally, managing one or more chronic conditions may be time consuming. Time consuming tasks may take the form of monitoring (e.g. checking blood glucose), keeping a diary, scheduling appointments, sorting and taking medications, exercising, meal planning, etc.. The Agency for Healthcare Research and Quality (2015) suggests the burden of these tasks significantly impact how patients manage their chronic conditions, and that patients often find it difficult to complete all these tasks in order to manage their condition effectively. Personally, I see examples of this every day at the hospital: Patients are not confident in their self-management ability and are therefore unable to demonstrate skill or awareness in regards to their condition. Despite receiving adequate medical attention from outstanding multidisciplinary teams, patients continue to show little interest in self-management, ultimately resulting in an overwhelming number of older adults who lack the confidence to manage one or more chronic conditions (Bodenheimer, 2005). Healthcare providers are being forced to seek new and innovative ways to connect with patients and reinforce educational material in order to give patients the confidence and skill to manage their care. I believe this objective to be most important because self-management is clinically proven to result in better outcomes. It is proven that support for patients and caregivers improve confidence in managing conditions. Recently, my hospital has added to its emphasis on education and follow up... Simply providing information to patients is not enough to build confidence, skill, nor the knowledge to manage their health. Therefore, nursing must collaborate to reinforce behaviors and promote better health outcomes in patients.
There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges.
Based on recent events that have transpired in the news, one might acknowledge that refugees and immigrants are a vulnerable population... many of whom are struggling with chronic illness, and undeniably experiencing challenges related to our healthcare delivery system. Several barriers exist for this group, including language and technology barriers, expectations of medical care, cultural differences, as well as unique ...
This public health presentation educates the community regarding Latino health and the need for more collaborate healthcare services to meet the demand.
1Health Care DisparityBlack AmericansHispanicsLatinos.docxfelicidaddinwoodie
1
Health Care Disparity
Black Americans
Hispanics/Latinos
Demographics
45.7 million, which is 14.3% of USA population.
15% of the USA population
Cultural Norms
Strong kinship bonds, strong work orientation, strong religious orientation, take care of their own, seniors are highly respected, don’t like to admit they need help, poverty impacts education, self-esteem, quality of life and life style across.
Strong family ties, strong church and community orientation, male dominance, age dominance, negative view on asking for help, take care of their own majority are roman catholic, distrust of government, modesty is important and very proud of heritage
Religious and Spiritual Beliefs
Have strong religious affiliation with Christian denominations and also Islam.
Have strong belief in the spirit world. Majority are roman CatholicsS
Primary Insurance Coverage
Most of them are not insured, but the affordable care act provision target at improving provisions that will highly improve their lives.
Six in ten Hispanic adults in USA lack health insurance.
Education
17% have attained bachelor’s degree
11% have attained bachelor’s degree
Medical Conditions
They reside at disadvantaged neighborhoods with increased risks for health disparities. Obesity in children is enormous
More than a quarter of its population lack usual health care provider. Hispanic adults have a low prevalence for many chronic diseases and a high prevalence for diabetes.
Outreach
Foundation of African American outreach program to provide assistance to Africa-Americans
Action plan to reduce racial and ethnic health disparities
Introduction
The health of a population is influenced by both its social and its economic circumstances and health care services it receives. The health care services provided to Hispanics and black in United States of America is low. Throughout the years we have seen advancements in the health care quality received by ethnic minorities groups. But there is still a large gap when comparing minorities with their white counterparts (Vicini, 2015). This has affected the two groups which have low income families and experience poor quality care. Hispanic and blacks are less likely to have a high school education. Disparities in quality of care are common among the blacks and Hispanics in USA. For instance adults of 65 years and above receive worse care than adults with 18-44 years. Poor people have worse access to care than the high income people (Lee et al., 2003).
Healthcare Disparities between the Blacks and the Latinos in USA
The healthcare insurance status for the blacks and Latinos is low and as a result it forms barriers to access to quality health care utilization. Language barriers in health care are associated with decrease in quality of care, safety, patient and clinical satisfaction and contribute to health disparities even among people with insurance. Statistics have shown when comparing blacks and Latinos to their whi ...
Shane Desautels is the director of NewWays learning. He has worked in the field of social services for over 30 years. As a literacy consultant to the South Side Health and Vitality Studies, he has provided expertise in the areas of technology literacy, adult and youth learning, empowerment strategies, and communication with traditionally marginalized groups.
Elementary CurriculaBoth articles highlight the fact that middle.docxtoltonkendal
Elementary Curricula
Both articles highlight the fact that middle-class students seem to benefit more from summer reading programs than their lower-SES peers. While we would hope that summer reading programs would have the same positive impact on all students, this information did not totally surprise me. Differences in funding, materials, and ability to recruit enough high-quality teachers for summer programs could be more difficult in lower-socioeconomic areas. In addition, the articles did not dive into other factors in the students’ lives that may be contributing to their performance such as attendance, how well-rested they are, trauma they have experiences that impacts their ability to focus during instruction, and the impact of being taught by a teacher who the students may not know or have a relationship with. Additionally, there could be a mismatch between the instructional practices and the specific needs of the students. Even though summer reading programs are only for a short time, I would challenge teachers to put energy into getting to know the students and building trust with them. This is a key foundation that is needed for learning to take place.
In challenging teachers during summer program and the regular school year to ”break out of the mold” to create better outcomes for students classified with low SES, in addition to building relationships with students, I would encourage them to build connections with their families. This may involve thinking outside the box and leaving their comfort zone. It could entail holding a parent-teacher conference off campus, closer to their home or in their community. It could also include providing resources and instructional videos to parents so they can help support their children at home. There are many parents who want to support their children academically, but they do not know how and may be uncomfortable asking the teacher for assistance. In addition, I would urge teachers to capitalize on the strengths and interests of their students to engage them in learning activities and provide them with opportunities to shine. We do not have to, and should not, be satisfied with the idea that low SES students will automatically not be able to perform. These students are capable of learning and growth just as much as any other student. I think data from test scores that demonstrate a gap between the performance of students classified as economically disadvantaged and not economically disadvantaged has led some people to hold the belief that students classified as low SES will not perform well. I think the way that school “report card” grades are published also perpetuates this belief, as it shows the test scores, but does not provide an explanation of or include any solutions for the many larger societal factors that contribute to those scores including high teacher turn over, lack of resources, child trauma, lack of sleep, lack of nutrition, crime & safety, and education level of parents.
It w.
Elementary Statistics (MATH220)
Assignment:
Statistical Project & Presentation
Purpose:
The purpose of this project is to supplement lecture material by having the students to do a case study on collecting, analyzing, and interpreting data.
***The best way to understand something is to experience it for yourself.
Guideline for Analyzing Data and Writing a Report
Below is a general outline of the topics that should be included in your report.
1.
Introduction.
State the topic of your study.
2.
Define Population.
Define the population that you intend for your study to represent.
3.
Define Variable.
Define clearly the variable that you obtained during your data collection; this should include information on how the variable is measured and what possible values this variable has.
4.
Data Collection.
Describe your data collection process, including your data source, your sampling strategy, and what steps you took to avoid bias.
5.
Study Design.
Describe the procedures you followed to analyze your data.
6.
Results: Descriptive Statistics.
Give the relevant descriptive statistics for the sample you collected.
7.
Results: Statistical Analysis.
Describe the results of your statistical analysis.
8.
Findings.
Interpret the results of your analysis in the context of your original research question. Was your hypothesis supported by your statistical analyses? Explain.
9.
Discussion.
What conclusions, if any, do you believe you can draw as a result of your study? If the results were not what you expected, what factors might explain your results? What did you learn from the project about the population you studied? What did you learn about the research variable? What did you learn about the specific statistical test you conducted?
.
Elements of Religious Traditions PaperWritea 700- to 1,050-word .docxtoltonkendal
Elements of Religious Traditions Paper
Write
a 700- to 1,050-word paper that does the following:
Describes these basic components of religious traditions and their relationship to the sacred
:
What a religious tradition says—its teachings, texts, doctrine, stories, myths, and others
What a religious tradition does—worship, prayer, pilgrimage, ritual, and so forth
How a religious tradition organizes—leadership, relationships among members, and so forth
Identifies key critical issues in the study of religion.
Includes specific examples from the various religious traditions described in the Week One readings that honor the sacred—such as rituals of the Igbo to mark life events, the vision quest as a common ritual in many Native American societies, or the influence of the shaman as a leader. You may also include examples from your own religious tradition or another religious tradition with which you are familiar.
Format
your paper consistent with APA guidelines
.
Elements of MusicPitch- relative highness or lowness that we .docxtoltonkendal
Elements of Music
Pitch- relative highness or lowness that we hear in a sound.
Tone- sound that has a definite pitch.
(For example striking a bat against a ball does not produce a D# but striking a D#
on a piano does)
Dynamics- the degree of loudness or softness in music
pp pianissimo /very soft
p piano /soft
mp mezzo-piano /medium-soft
mf mezzo-forte /medium-loud
f forte /loud
ff fortissimo /very loud
When dynamics are altered in a piece of music, they are termed as follows:
decrescendo/ diminuendo gradually softer
crescendo gradually louder
Timbre/Tone Color- the character or quality of a sound.
dark, bright, mellow, cool, metallic, rich, brilliant, thin, etc.
Rhythm- a) the flow (or pattern) of music through time. b) the particular arrangement of
note lengths in a piece of music.
Syncopation- An accent placed on a beat where it is not normally expected.
Beat- the steady pulse in a piece of music.
Downbeat- the first or stressed beat of a measure.
Meter- the pattern in which beats are organized within a piece of music.
Examples:
3/4= three beats per measure
4/4= four beats per measure
6/8= six beats per measure
*In some musics, meter is not present- this is termed non-metric.
(Ex: Chant, some 20th century genres, world musics).
Melody- a series of single notes that add up to a recognizable whole.
*A melodic line has a shape -it ascends and descends in a series of continuous pitches.
Sequence- a repetition of a pattern at a higher or lower pitch.
Phrase- A short unit of music within a melodic line.
Cadence- The rest at the end of a musical phrase. Think of this as a musical period at the
end of a sentence.
Harmony- A) How chords are constructed and how they follow each other. B) The
relationship of tones when sounded in a group.
Chord- a combination of three or more tones sounded at once.
Consonance- a stable tone combination in a chord
Dissonance- and unstable tone combination in a chord; usually, an expected
and stable resolution will follow.
Tonic- a) the main key of a piece of music. b) the first note of a scale
Key- the central tone or scale in a piece of music.
(example: A major, b minor)
Modulation- a shift from one key to another within the same piece of music.
Texture- layering of musical sounds or instruments within a piece of music.
Monophonic- single, unaccompanied melodic line.
Homophonic- a melody with an accompaniment of chords.
Polyphonic- th.
Elevated Blood Lead Levels in Children AssociatedWith the Fl.docxtoltonkendal
Elevated Blood Lead Levels in Children Associated
With the Flint Drinking Water Crisis: A Spatial
Analysis of Risk and Public Health Response
Mona Hanna-Attisha, MD, MPH, Jenny LaChance, MS, Richard Casey Sadler, PhD, and Allison Champney Schnepp, MD
Objectives. We analyzed differences in pediatric elevated blood lead level incidence
before and after Flint, Michigan, introduced a more corrosive water source into an aging
water system without adequate corrosion control.
Methods. We reviewed blood lead levels for children younger than 5 years before
(2013) and after (2015) water source change in Greater Flint, Michigan. We assessed the
percentage of elevated blood lead levels in both time periods, and identified geo-
graphical locations through spatial analysis.
Results. Incidence of elevated blood lead levels increased from 2.4% to 4.9% (P < .05)
after water source change, and neighborhoods with the highest water lead levels ex-
perienced a 6.6% increase. No significant change was seen outside the city. Geospatial
analysis identified disadvantaged neighborhoods as having the greatest elevated blood
lead level increases and informed response prioritization during the now-declared public
health emergency.
Conclusions. The percentage of children with elevated blood lead levels increased
after water source change, particularly in socioeconomically disadvantaged neighbor-
hoods. Water is a growing source of childhood lead exposure because of aging infra-
structure. (Am J Public Health. 2016;106:283–290. doi:10.2105/AJPH.2015.303003)
See also Rosner, p. 200.
In April 2014, the postindustrial city ofFlint, Michigan, under state-appointed
emergency management, changed its water
supply from Detroit-supplied Lake Huron
water to the Flint River as a temporary
measure, awaiting a new pipeline to Lake
Huron in 2016. Intended to save money, the
change in source water severed a half-
century relationship with the Detroit Water
and Sewage Department. Shortly after the
switch to Flint River water, residents voiced
concerns regarding water color, taste, and
odor, and various health complaints in-
cluding skin rashes.1 Bacteria, including
Escherichia coli, were detected in the distri-
bution system, resulting in Safe Drinking
Water Act violations.2 Additional disinfec-
tion to control bacteria spurred formation of
disinfection byproducts including total tri-
halomethanes, resulting in Safe Drinking
Water Act violations for trihalomethane
levels.2
Water from the Detroit Water and
Sewage Department had very low corrosivity
for lead as indicated by low chloride, low
chloride-to-sulfate mass ratio, and presence
of an orthophosphate corrosion inhibitor.3,4
By contrast, Flint River water had high
chloride, high chloride-to-sulfate mass ratio,
and no corrosion inhibitor.5 Switching
from Detroit’s Lake Huron to Flint River
water created a perfect storm for lead leach-
ing into drinking water.6 The aging Flint
water distribution system contains a hig.
Elements of the Communication ProcessIn Chapter One, we learne.docxtoltonkendal
Elements of the Communication Process
In Chapter One, we learned communication is the process of creating or sharing meaning in informal conversation, group interaction, or public speaking. To understand how the process works, we described the essential elements in the process.
For the following interaction, identify the contexts, participants, channels. message, interference (noise), and feedback.
"Maria and Damien are meandering through the park, talking and drinking bottled water. Damien finishes his bottle, replaces the lid, and tosses the bottle into the bushes at the side of the path. Maria, who has been listening to Damien talk, comes to a stop, puts her hand on her hips, stares at Damien, and says angrily, " I can't believe what you just did! Damien blushes, averts his gaze, and mumbles, "Sorry, I'll get it- I just wasn't thinking." As the tension drains from Maria's face. she gives her head a playful toss, smiles, and says, Well, just see that it doesn't happen again.
1. Contexts
a. Physical
b. Social
c. Historical
d. Psychological
2. Participants
3. Channels
4. Message
5. Interference (Noise)
6. Feedback
.
Elements of Music #1 Handout1. Rhythm the flow of music in te.docxtoltonkendal
Elements of Music #1 Handout
1. Rhythm
the flow of music in terms of time
2. Beat
the pulse that recurs regularly in music
3. Meter
the regular pattern of stressed and unstressed beats
4. Tempo
the speed of the beats in a piece of music
5. Polyrhythm
two or more rhythm patterns occurring simultaneously
6. Pitch
the perceived highness or lowness of a musical sound
7. Melody
a series of consecutive pitches that form a cohesive musical entity
8. Counterpoint
two or more independent lines with melodic character occurring at the same time
9. Harmony
the simultaneous sounds of several pitches, usually in accompanying a melody
10. Dynamics
the amount of loudness in music
11. Timbre
tone quality or tone color in music
12. Form
the pattern or plan of a musical work
Framework for Improving
Critical Infrastructure Cybersecurity
Version 1.1
National Institute of Standards and Technology
April 16, 2018
April 16, 2018 Cybersecurity Framework Version 1.1
This publication is available free of charge from: https://doi.org/10.6028/NIST.CSWP.04162018 ii
No t e t o Rea d er s o n t h e U p d a t e
Version 1.1 of this Cybersecurity Framework refines, clarifies, and enhances Version 1.0, which
was issued in February 2014. It incorporates comments received on the two drafts of Version 1.1.
Version 1.1 is intended to be implemented by first-time and current Framework users. Current
users should be able to implement Version 1.1 with minimal or no disruption; compatibility with
Version 1.0 has been an explicit objective.
The following table summarizes the changes made between Version 1.0 and Version 1.1.
Table NTR-1 - Summary of changes between Framework Version 1.0 and Version 1.1.
Update Description of Update
Clarified that terms like
“compliance” can be
confusing and mean
something very different
to various Framework
stakeholders
Added clarity that the Framework has utility as a structure and
language for organizing and expressing compliance with an
organization’s own cybersecurity requirements. However, the
variety of ways in which the Framework can be used by an
organization means that phrases like “compliance with the
Framework” can be confusing.
A new section on self-
assessment
Added Section 4.0 Self-Assessing Cybersecurity Risk with the
Framework to explain how the Framework can be used by
organizations to understand and assess their cybersecurity risk,
including the use of measurements.
Greatly expanded
explanation of using
Framework for Cyber
Supply Chain Risk
Management purposes
An expanded Section 3.3 Communicating Cybersecurity
Requirements with Stakeholders helps users better understand
Cyber Supply Chain Risk Management (SCRM), while a new
Section 3.4 Buying Decisions highlights use of the Framework
in understanding risk associated with commercial off-the-shelf
products and services. Additional Cyber SCRM criteria we.
Elements of Music Report InstrumentsFor the assignment on the el.docxtoltonkendal
Elements of Music Report Instruments
For the assignment on the elements of music, students will write a report with a minimum of 300 words.
Students must select one element of music that they consider to be the most important element:
Melody
Rhythm
Harmony
Form
When writing the report, be sure you address the following questions:
Why did you select this element from among all the rest?
Do you think that all kinds of music could exist without your selected element? Elaborate on your view.
Describe a piece of music that highlights the use of your selected element.
I encourage students do research on their element of music in order to get ideas for their reports. All reports must be original works!
Do not quote any source or anybody’s thoughts. Quotes are not permitted in this Instruments Report. I am interested in your own personal thoughts, opinions, and the material you have learned from your research.
.
Elements of GenreAfter watching three of the five .docxtoltonkendal
Elements of Genre
After watching three of the five movie clips listed in the
Multimedia
section, above, describe how they fit into a specific genre (or subgenre) as explained in the text. What elements of the film are characteristic of that genre? How does it fulfill the expectations of that genre? How does it play against these expectations?
Your initial post should be at least 150 words in length. Support your claims with examples from required material(s) and/or other scholarly resources, and properly cite any references.
.
Elements of DesignDuring the process of envisioning and designing .docxtoltonkendal
Elements of Design
During the process of envisioning and designing a film, the director, production designer, and art director (in collaboration with the cinematographer) are concerned with several major spatial and temporal elements. These design elements punctuate and underscore the movement of figures within the frame, including the following: setting, lighting, costuming, makeup, and hairstyles. Choose a scene from movieclips.com. In a three to five page paper, (excluding the cover and reference pages) analyze the mise-en-scène.
Respond to the following prompts with at least one paragraph per bulleted topic:
Identify the names of the artists involved in the film’s production: the director, the production designer, and the art director. Describe in separate paragraphs each artist’s role in the overall design process. Conduct additional research if necessary, citing your book, film, and other external sources correctly in APA format.
Explain how the artists utilize lighting in the scene. How does the lighting affect our emotional understanding of certain characters? What sort of mood does the lighting evoke? How does lighting impact the overall story the filmmaker is attempting to tell?
Describe the setting, including the time period, location, and culture in which the film takes place.
Explain what costuming can tell us about a character. In what ways can costuming be used to reflect elements of the film's plot?
Explain how hairstyle and makeup can help tell the story. What might hairstyle and makeup reveal about the characters?
Discuss your opinion regarding the mise-en-scène. Do the elements appear to work together in a harmonious way? Does the scene seem discordant? Do you think the design elements are congruent with the filmmaker’s vision for the scene?
.
Elements of Critical Thinking [WLOs 2, 3, 4] [CLOs 2, 3, 4]P.docxtoltonkendal
Elements of Critical Thinking [WLOs: 2, 3, 4] [CLOs: 2, 3, 4]
Prepare:
Prior to beginning work on this discussion forum, in preparation for discussing the importance of critical thinking skills,
Read the articles
Common Misconceptions of Critical Thinking
Combating Fake News in the Digital Age
6 Critical Thinking Skills You Need to Master Now (Links to an external site.)
Teaching and Learning in a Post-Truth world: It’s Time for Schools to Upgrade and Reinvest in Media Literacy Lessons
Critical Thinking and the Challenges of Internet (Links to an external site.)
Watch the videos
Fake News: Part 1 (Links to an external site.)
Critical Thinking
(Links to an external site.)
Review the resources
Critical Thinking Skills (Links to an external site.)
Valuable Intellectual Traits (Links to an external site.)
Critical Thinking Web (Links to an external site.)
Reflect:
Reflect on the characteristics of a critical thinker. Critical thinking gets you involved in a dialogue with the ideas you read from others in this class. To be a critical thinker, you need to be able to summarize, analyze, hypothesize, and evaluate new information that you encounter.
Write:
For this discussion, you will address the following prompts. Keep in mind that the article or video you’ve chosen should not be about critical thinking, but should be about someone making a statement, claim, or argument related to your Final Paper topic. One source should demonstrate good critical thinking skills and the other source should demonstrate the lack or absence of critical thinking skills. Personal examples should not be used.
Explain at least five elements of critical thinking that you found in the reading material.
Search the Internet, media, or the Ashford University Library, and find an example in which good critical thinking skills are being demonstrated by the author or speaker. Summarize the content and explain why you think it demonstrates good critical thinking skills.
Search the Internet, media, or the Ashford University Library, and find an example in which the author or speaker lacks good critical thinking skills. Summarize the content and explain why you think it demonstrates the absence of good, critical thinking skills.
Your initial post should be at least 250 words in length, which should include a thorough response to each prompt. You are required to provide in-text citations of applicable required reading materials and/or any other outside sources you use to support your claims. Provide full reference entries of all sources cited at the end of your response. Please use correct APA format when writing in-text citations (see
In-Text Citation Helper (Links to an external site.)
) and references (see
Formatting Your References List (Links to an external site.)
).
Reflecting on General Education and Career [WLOs: 2, 3, 4] [CLOs: 2, 3, 4]
Prepare:
Prior to beginning work on this discussion forum, read the articles
Teaching Writing S.
Elements of DesignDuring the process of envisioning and design.docxtoltonkendal
Elements of Design
During the process of envisioning and designing a film, the director, production designer, and art director (in collaboration with the cinematographer) are concerned with several major spatial and temporal elements. These design elements punctuate and underscore the movement of figures within the frame, including the following: setting, lighting, costuming, makeup, and hairstyles. Choose a scene from movieclips.com. In a three to five page paper, (excluding the cover and reference pages) analyze the mise-en-scène.
Respond to the following prompts with at least one paragraph per bulleted topic:
Identify the names of the artists involved in the film’s production: the director, the production designer, and the art director. Describe in separate paragraphs each artist’s role in the overall design process. Conduct additional research if necessary, citing your book, film, and other external sources correctly in APA format.
Explain how the artists utilize lighting in the scene. How does the lighting affect our emotional understanding of certain characters? What sort of mood does the lighting evoke? How does lighting impact the overall story the filmmaker is attempting to tell?
Describe the setting, including the time period, location, and culture in which the film takes place.
Explain what costuming can tell us about a character. In what ways can costuming be used to reflect elements of the film's plot?
Explain how hairstyle and makeup can help tell the story. What might hairstyle and makeup reveal about the characters?
Discuss your opinion regarding the mise-en-scène. Do the elements appear to work together in a harmonious way? Does the scene seem discordant? Do you think the design elements are congruent with the filmmaker’s vision for the scene?
.
Elements of a contact due 16 OctRead the Case Campbell Soup Co. v..docxtoltonkendal
Elements of a contact due 16 Oct
Read the Case Campbell Soup Co. v. Wentz in the text. Answer the following questions:
1. What were the terms of the contract between Campbell and the Wentzes?
2. Did the Wentzes perform under the contract?
3. Did the court find specific performance to be an adequate legal remedy in this case?
4. Why did the court refuse to help Campbell in enforcing its legal contract?
5. How could Campbell change its contract in the future so as to avoid the unconsionability problem?
Facts:
Per
a
written
contract
between
Campbell
Soup
Company
(a
New
Jersey
company)
and
the
Wentzes
(carrot
farmers
in
Pennsylvania),
the
Wentzes
would
deliver
to
Campbell
all
the
Chantenay
red
cored
carrots
to
be
grown
on
the
Wentz
farm
during
the
1947
season.
The
contract
price
for
the
carrots
was
$30
per
ton.
The
contract
between
Campbell
Soup
and
all
sellers
of
carrots
was
drafted
by
Campbell
and
it
had
a
provision
that
prohibited
farmers/sellers
from
selling
their
carrots
to
anyone
else,
except
those
carrots
that
were
rejected
by
Campbell.
The
contract
also
had
a
liquidated
damages
provision
of
$50
per
ton
if
the
seller
breached,
but
it
had
no
similar
provision
in
the
event
Campbell
breached.
The
contract
not
only
allowed
Campbell
to
reject
nonconforming
carrots,
but
gave
Campbell
the
right
to
determine
who
could
buy
the
carrots
it
had
rejected.
The
Wentzes
harvested
100
tons
of
carrots,
but
because
the
market
price
at
the
time
of
harvesting
was
$90
per
ton
for
these
rare
carrots,
the
Wentzes
refused
to
deliver
them
to
Campbell
and
sold
62
tons
of
their
carrots
to
a
farmer
who
sold
some
of
those
carrots
to
Campbell.
Campbell
sued
the
Wentzes,
asking
for
the
court's
order
to
stop
further
sale
of
the
contracted
carrots
to
others
and
to
compel
specific
performance
of
the
contract.
The
trial
court
ruled
for
the
Wentzes
and
Campbell
appealed.
Issues:
Is
specific
performance
an
appropriate
legal
remedy
in
this
case
or
is
the
contract
unconscionable?
Discussion:
In
January
1948,
it
was
virtually
impossible
to
obtain
Chantenay
carrots
in
the
open
market.
Campbell
used
Chantenay
carrots
(which
are
easier
to
process
for
soup
making
than
other
carrots)
in
large
quantities
and
furnishes
the
seeds
to
farmers
with
whom
it
contracts.
Campbell
contracted
for
carrots
long
ahead,
and
farmers
entered
into
the
contract
willingly.
If
the
facts
of
this
case
were
this
simple,
specific
performance
should
have
been
granted.
However,
the
problem
is
with
the
contract
itself,
which
was
one-sided.
According
to
the
appellate
court,
the
most
direct
example
of
unconscionability
was
the
provision
that,
under
certain
.
Elements for analyzing mise en sceneIdentify the components of.docxtoltonkendal
Elements for analyzing mise en scene
Identify the components of the shot, but explaining the meaning or significance behind those components and connecting the shot to the themes of the film
1. Dominant: Where is the eye attracted first? Why?
2. Lighting key: High key? Low key? High contrast? Some combination of these?
3. Shot and camera proxemics: What type of shot? How far away is the camera from the action?
4. Angle: Is the viewer (through the eye of the camera) looking up or down on the subject? Or is the camera neutral (eye level)?
5. Color values: What is the dominant color? Are there contrasting foils? Is there color symbolism?
6. Lens/filter/stock: How do these distort or comment on the
photographed materials?
7. Subsidiary contrasts: What are the main eye-stops after taking in the dominant?
8. Density: How much visual information is packed into the image? Is the texture stark, moderate, or highly detailed?
9. Composition: How is the two-dimensional space segmented and organized? What is the underlying design?
10. Form: Open or closed? Does the image suggest a window that arbitrarily isolates a fragment of the scene? Or a proscenium arch, in which the visual elements are carefully arranged and held in balance?
11. Framing: Tight or loose? Do characters have little to no room to move, or can they move freely without impediments?
12. Depth: On how many planes is the image composed? Does the background or foreground comment in any way on the midground?
13. Character placement: What part of the framed space do the characters occupy? Center? Top? Bottom? Edges? Why?
14. Staging positions: Which way do the characters look vis-à-vis the camera?
15. Character proxemics: How much space is between the
characters?
What are the 4 distinct formal elements that make up a film's mise en scene?
• staging of the action
• physical setting and decor
• the manner in which these materials are framed
• the manner in which they are photographed
.
Elements in the same row have the same number of () levelsWhi.docxtoltonkendal
Elements in the same row have the same number of (*) levels
Which elements in B O U L A N would be in the same family? Which would have the same number of energy levels? Highest mass? Lowest mass?
Which is more reactive? Uranium or Lithium
Will elements B and U lose electrons in a chemical reactor?
Will elements B and U form positive or negative ions?
Thanks so much (:
.
ELEG 421 Control Systems Transient and Steady State .docxtoltonkendal
ELEG 421
Control Systems
Transient and Steady State
Response Analyses
Dr. Ashraf A. Zaher
American University of Kuwait
College of Arts and Science
Department of Electrical and Computer Engineering
Layout
2
Objectives
This chapter introduces the analysis of the time response of different
control systems under different scenarios. Only first and second order
systems will be considered in details using analytical and numerical
methods. Extension to higher order systems will be developed. Both
transient and steady state responses will be evaluated. Stability analysis
will be analyzed for different kinds of feedback, while investigating the
effect of both proportional and derivative control actions on the
performance of the closed-loop system. Finally systems types and
steady state errors will be calculated for unity feedback.
Outcomes
By the end of this chapter, students will be able to:
evaluate both transient/steady state responses for control systems,
analyze the stability of closed-loop LTI systems,
investigate the effect of P and I control actions on performance, and
understand dominant dynamics of higher order systems.
Dr. Ashraf Zaher
Introduction
3
Test signals
Transient response
Steady state response
Analytical techniques, and
Numerical (simulation) techniques.
Stability (definition and analysis methods),
Relative stability, and
Effect of P/I control actions on stability and performance.
Summary of the used systems:
First order systems,
Second order systems, and
Higher order systems.
Dr. Ashraf Zaher
Test Signals
4 Dr. Ashraf Zaher
Impulse function:
Used to simulate shock inputs,
Laplace transform: 1.
Step function:
Used to simulate sudden disturbances,
Laplace transform: 1/s.
Ramp function:
Used to simulate gradually changing inputs,
Laplace transform: 1/s2.
Sinusoidal function(s):
Used to test response to a certain frequency,
Laplace transform: s/(s2+ω2) for cos(ωt) and ω/(s2+ω2) for sin(ωt).
White noise function:
Used to simulate random noise,
It is a stochastic signal that is easier to deal with in the time domain.
Total response:
C(s) = R(s)*TF(s) = Ctr(s) + Css(s) → c(t) = ctr(t) + css(t)
Fundamentals
5 Dr. Ashraf Zaher
Definitions:
Zeros (Z) of the TF
Poles (P) of the TF
Transient Response (Natural)
Steady State Response (Forced)
Total Response
Limits:
Initial values
Final values
Systems (?Zs):
First order (one P)
Second order (two Ps)
Higher order!
More:
Stability and relative stability
Steady state errors (unity feedback)
First Order Systems
6 Dr. Ashraf Zaher
TF:
T: time constant
Unit Step Response:
1
1
)(
)(
+
=
TssR
sC
)/1(
11
1
1
1
11
)(
TssTs
T
sTss
sC
+
−=
+
−=
+
=
Ttetc /1)( −−=
632.01)( 1 =−== −eTtc
T
e
Tdt
tdc Tt
t
11)( /
0
== −
=
01)0( 0 =−== etc
11)( =−=∞= −∞etc
First Order Systems.
Element 010 ASSIGNMENT 3000 WORDS (100)Task Individual assign.docxtoltonkendal
Element 010 ASSIGNMENT: 3000 WORDS (100%)
Task: Individual assignment (3000 words)
Weighting: 100%
Assessment Case Study:
Greenland Garden Centre
[1]
Jon Smith spread his arms widely as he surveyed his garden centre.
‘Of course the whole market for leisure products and services, especially garden-related products, has been expanding over the last few years. Even so, we have been particularly successful. Partly this is because we are conveniently located, but it is also because we have developed a reputation for excellent service. Customers like coming to us for advice. We have also been successful in attracting some of the ‘personality gardeners’ from television to make special appearances. My main ambition now is to fully develop all of our twelve hectares to make the centre a place people will want to visit in its own right. I envisage the centre developing into almost a mini gardening theme park with special gardens, beautiful grounds and special events.’
Greenland is a large village situated in the Cotswolds, a popular tourist area of the UK. It has an interesting range of shops and restaurants, mainly catering for the tourist trade. About half a mile outside the village is the Greenland Garden Centre. The garden centre is served by a good network of main roads but is inaccessible by public transport.
Growth over the last five years has been dramatic and the garden centre now sells many other goods as well as gardening requisites. It also has a restaurant. It is open seven days a week, only closing on Christmas Day. Its opening hours are Monday– Saturday 9 a.m. to 6 p.m. and Sunday 10 a.m. to 5 p.m. all year round.
Outside the centre
The centre has a large car park which can accommodate about 350 cars. Outside the entrance a map indicates the various areas in the garden centre. Most customers walk round the grounds before making their purchases. The length of time people spend in the centre varies but, according to a recent study, averages 53 minutes during the week and 73 minutes at weekends.
The same study shows the extent to which the number of customers arriving at the garden centre varies depending on the time of year, day of the week, and time of day. There are two peaks in customer numbers, one during the late spring/early summer period and another in the build up to Christmas, as Greenland puts on particularly good Christmas displays.
Indoor sales area
The range of goods has increased dramatically over the past few years and now includes items such as:
pets and aquatics
seeds
fertilisers
indoor pots and plants
gardening equipment
garden lighting
conservatory-style furniture
outdoor clothing
picture gallery
books and toys
delicatessen
wine
kitchen equipment
soft furnishing
outdoor eating equipment
gifts, stationery, cards, aromatherapy products
freshly cut flowers
dried flowers.
Outside sales area
In the open air and in large glasshouses there is a complete range of plants, shrubs and trees. Gre.
ELEG 320L – Signals & Systems Laboratory Dr. Jibran Khan Yous.docxtoltonkendal
ELEG 320L – Signals & Systems Laboratory /Dr. Jibran Khan Yousafzai Lab 4
1
LAB 4: CONVOLUTION
Background & Concepts
Convolution is denoted by:
𝑦[𝑛] = 𝑥[𝑛] ∗ ℎ[𝑛]
Your book has described the "flip and shift" method for performing convolution. First, we
set up two signals 𝑥[𝑘] and ℎ[𝑘]:
Flip one of the signals, say ℎ[𝑘], to form ℎ[−𝑘]:
ELEG 320L – Signals & Systems Laboratory /Dr. Jibran Khan Yousafzai Lab 4
2
Shift ℎ[−𝑘] by n to form ℎ[𝑛 − 𝑘]. For each value of 𝑛, form 𝑦[𝑛] by multiplying and
summing all the element of the product of𝑥[𝑘]ℎ[𝑛 − 𝑘], −∞ < 𝑘 < ∞. The figure
below shows an example of the calculation of𝑦[1]. The top panel shows𝑥[𝑘]. The
middle panel showsℎ[1 − 𝑘]. The lower panel shows𝑥[𝑘]𝑦[1 − 𝑘]. Note that this is a
sequence on a 𝑘 axis. The sum of the lower sequence over all k gives 𝑦[1] = 2.
We repeat this shifting, multiplication and summing for all values of 𝑛 to get the
complete sequence 𝑦[𝑛]:
ELEG 320L – Signals & Systems Laboratory /Dr. Jibran Khan Yousafzai Lab 4
3
The conv Command
conv(x,h) performs a 1-D convolution of vectors 𝑥 and ℎ. The resulting vector 𝑦
has length length(𝑦) = length(𝑥) + length(ℎ) − 1. Imagine vector 𝑥 as being
stationary and the flipped version of ℎ is slid from left to right. Note that conv(x,h) =
conv(h,x). An example of the convolution of two signals and plotting the result is
below:
>> x = [0.5 0.5 0.5]; %define input signal x[n]
>> h = [3.0 2.0 1.0]; %unit-pulse response h[n]
>> y = conv(x,h); %compute output y[n] via convolution
>> n = 0:(length(y)-1); %for plotting y[n]
>> stem(n,y) % plot y[n]
>> grid;
>> xlabel('n');
>> ylabel('y[n]');
>> title('Output of System via Convolution');
ELEG 320L – Signals & Systems Laboratory /Dr. Jibran Khan Yousafzai Lab 4
4
Deconvolution
The command [q,r] = deconv(v,u), deconvolves vector u out of vector v, using long
division. The quotient is returned in vector q and the remainder in vector r such that
v = conv(u,q)+r. If u and v are vectors of polynomial coefficients, convolving them is
equivalent to multiplying the two polynomials, and deconvolution is polynomial
division. The result of dividing v by u is quotient q and remainder r. An examples is
below:
If
>> u = [1 2 3 4];
>> v = [10 20 30];
The convolution is:
>> c = conv(u,v)
c =
10 40 100 160 170 120
Use deconvolution to recover v.
>> [q,r] = deconv(c,u)
q =
10 20 30
r =
0 0 0 0 0 0
This gives a quotient equal to v and a zero remainder.
Structures
Structures in Matlab are just like structures in C. They are basically containers that
allow one
Electronic Media PresentationChoose two of the following.docxtoltonkendal
Electronic Media Presentation
Choose
two of the following types of electronic media:
Radio
Sound recording
Motion pictures
Broadcast television
Research
the history of the media types your team selected. Include the following information in your presentation:
Introduction
Notable founders and parent organizations of your electronic media types
Notable historical dates
Dates of mergers with other radio stations, record production companies, motion picture companies, or television networks to form a large media conglomerate
Date the media types launched their websites, became active on the Internet, or became active in social media integration
Identify past, present, and future challenges confronting these types of media. How has the digital era affected them? Which types are best suited to adapt to the future? Explain why
How do these challenges affect advertising in these organizations--outside companies advertising--and advertising for these media--companies promoting themselves to others? What are innovative advertising strategies these media have engaged in?
What are two similarities and two differences between the two media types?
Conclusion
Present your Electronic Media Presentation.
These are 10- to 12-slideMicrosoft
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PowerPoint
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presentations with notes.
.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
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He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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1. Educating Patients: Understanding Barriers,
Learning Styles, and Teaching Techniques
Linda Beagley, MS, BSN, RN, CPAN
Health care delivery and education has become a challenge for
providers.
Linda Beagley, M
cator, Swedish Cov
Conflict of intere
Address corresp
nant Hospital, 51
e-mail address: lbe
� 2011 by Ame
1089-9472/$36.
doi:10.1016/j.jo
Journal of PeriAnesth
Nurses and other professionals are challenged daily to assure
that the
patient has the necessary information to make informed
decisions.
Patients and their families are given a multitude of information
2. about
their health and commonly must make important decisions from
these
facts. Obstacles that prevent easy delivery of health care
information
include literacy, culture, language, and physiological barriers. It
is up
to the nurse to assess and evaluate the patient’s learning needs
and read-
iness to learn because everyone learns differently. This article
will
examine how each of these barriers impact care delivery along
with
teaching and learning strategies will be examined.
Keywords: patient education, barriers, culture, literacy,
perianesthesia
nursing.
� 2011 by American Society of PeriAnesthesia Nurses
EDUCATING PATIENTS HAS become a challenge
for health care providers because the patient
length of stay has decreased and the need to deliver
complex information has increased. A new version
of the melting pot society requires special efforts
3. by health care professionals to ensure that the pa-
tient understands the information given to him or
her. Barriers that inhibit patient education are liter-
acy, language, culture, and physiological obstacles.
Assessing and evaluating the learning needs of
the patient are essential before planning and im-
plementation of an educational plan. Presenting
a well-formulated plan will increase the likelihood
of a successful recovery for the patient. In this
article, barriers will be dissected and strategies
examined to determine what will best suit the edu-
cational needs of the patient.
S, BSN, RN, CPAN, is a PACU Clinical Edu-
enant Hospital, Chicago, IL.
st: None to report.
ondence to Linda Beagley, Swedish Cove-
40 N. California Ave, Chicago, IL 60625;
[email protected]
rican Society of PeriAnesthesia Nurses
00
4. pan.2011.06.002
esia Nursing, Vol 26, No 5 (October), 2011: pp 331-337
Adult Learning
To effectively educate patients, health care pro-
viders must have an understanding of the princi-
ples of adult learning. Malcolm Knowles, who
began to study adult learners in the 1960s, is
known as the father of adult learning principles be-
cause of his extensive writing on adult education.
The term andragogy, the art and science of teach-
ing adults, is synonymous with that of Knowles.
He deduced that adults learn differently than chil-
dren. His studies determined five assumptions on
learning: self-concept, experience, readiness to
learn, orientation to learning, and motivation to
learn.
1
According to Knowles, as a person ma-
tures, his self-concept moves from one of being
a dependent personality towards one of being
a self-directed human being. Humans accumulate
5. a growing reservoir of knowledge, followed by
a readiness to learn, which increasingly is oriented
towards developmental tasks related to social roles
with immediate application of their new knowl-
edge. Knowles’ final assumption reflects the moti-
vation of learning as moving from external to
internal.
1,2
Table 1 compares and summarizes
Knowles’ assumption regarding the adult (andra-
gogy) and the child (pedagogy) learner.
331
mailto:[email protected]
http://dx.doi.org/10.1016/j.jopan.2011.06.002
Table 1. Assumptions Differences of Pedagogy and
Andragogy1,2
Assumptions Pedagogy Andragogy
Self-concept Dependency Self-directed
Experience Happens to learner Rich resource
Readiness Biologic and academic development Evolving social
6. and life roles
Orientation to learning Logical; directed by teacher Life
centered; task/problem centered
Motivation External approval of teacher Internal drive; life
goals
332 LINDA BEAGLEY
Literacy Barrier
Literacy is defined as ‘‘an individual’s ability to
read, write and speak in English and compute
and solve problems at levels of proficiency neces-
sary to function on the job and in society, to
achieve one’s goals, and to develop one’s knowl-
edge and potential.’’
3
Illiteracy does not discrimi-
nate; it can be found in all populations, and
a person’s grade level is not an accurate gauge
for reading ability.
4
Having any level of illiteracy
can cause a number of problems with activities
of daily living, such as analyzing a transportation
7. schedule, following directions, understanding rec-
ipes, and completing job applications. Low liter-
acy is described as those people who have the
ability to read, write, and understand information
only at the seventh grade reading level. According
to the US Department of Health and Human Ser-
vices (DHHS),
3
demographics does play a role in
literacy; certain groups demographically have
a higher prevalence of low literacy. Table 2 out-
lines this population.
Low literacy and low health literacy are related but
not interchangeable. Health literacy is defined in
Healthy People 2010 as ‘‘the degree to which indi-
viduals have the capacity to obtain, process, and
understand basic health information and services
needed to make appropriate health decisions.’’
5
Low health literacy is content specific. An individ-
8. Table 2. Demographics of Low Literacy3
Fewer years of education
Lower cognitive ability
Elderly
Some racial or ethnic groups from the South or
Northeast
Female
Incarceration
Low income status
ual may be able to read and write in certain con-
texts but struggle to comprehend the unfamiliar
vocabulary and concepts found in health-related
materials or instructions.
5
According to the US
Department of Education, which conducts a na-
tionwide survey of adult Americans to evaluate lit-
eracy skills,
5
an estimated nearly one half of
9. Americans (90 million) have difficulty understand-
ing and acting on health information. These stud-
ies have linked low health literacy with delayed
diagnosis, poor disease management skills, and
higher health care costs. These same individuals
demonstrate a limited understanding of their dis-
ease processes resulting in worse health care out-
comes.
6
Unnecessary health care costs ranging
from $106 to $238 billion are attributed to limited
health literacy.
7
Factors associated with health literacy are depen-
dent on the skills, preferences, and expectations
of health information providers. At times, health
care professionals may be oblivious to the effect
of limited health literacy on patients and the health
care system. In one study
7
of 240 health care pro-
viders and students, researchers found fewer than
10. 12% of participants were aware of their degree of
limited health literacy. Twenty-five percent were
found to have a common misconception that
health literacy could be determined by race, eth-
nicity, culture, age, or socioeconomic status.
7
To
heighten matters, responders inaccurately be-
lieved that patients with a higher level of education
were not at risk for having limited health literacy
(7.4%). In health care, nurses comprise the largest
group of providers and are responsible for ensur-
ing patient education. The researchers recom-
mend health literacy education for nurses during
the education process.
Cutilli
8
completed a systematic review of the liter-
ature for the purpose of analyzing and evaluating
the research on health literacy and the elderly.
11. EDUCATING PATIENTS 333
Age becomes an important demographic marker
with an inverse relationship to health literacy.
Cutilli found that as the patient’s age increases,
the health literacy level decreases. This is an
important element because of the aging popula-
tion in the United States and the projected trend
of aging. By 2030, it is estimated that 20% of the
population will be 65 years and older.
9
The
Federal Interagency Forum on Aging
9
reports older
Americans are proportionately more likely to have
below basic health literacy than other age groups.
Thirty-nine percent of people aged 75 years or
older have below average health literacy skills
compared to 23% of people aged 65 to 74 years
and 13% of people aged 50 to 64 years.
Language and Culture Barrier
12. The United States has been known as a melting pot
of diversity over the last 100 plus years. Some
changes, however, have occurred from those early
years. Ethnicities are found in large urban neigh-
borhoods, as well as the suburbs and rural areas
of the country. The diversity now existing across
the country has presented many challenges for
health care providers. In 2001, DHHS published
national standards on culturally and linguistically
appropriate services. These DHHS standards
10
re-
quired health care institutions to demonstrate cul-
tural competency while caring for patients in
a manner responsive to their beliefs, interpersonal
styles, attitudes, language, and behaviors of the in-
dividual and required that care be provided in
a manner that demonstrates respect for individual
dignity, personal preference, and cultural differ-
ences.
13. Health care providers must be knowledgeable of
cultural competencies. Nurses should have aware-
ness of biases and prejudices by examining gener-
alizations they might use routinely about cultures
other than their own. Any biases must be con-
fronted. A commitment to learn more about the
cultures that have been generalized in the past
must be made.
11
Second, core cultural values
need to be examined and understood about the
varying populations that frequent the institution.
Cultures have several core values on which all
other values are based.
12
This foundation is a start-
ing point for health care providers in understand-
ing different cultures.
A challenging aspect is the ability to communicate
effectively to the patient whose native language is
14. not English. Thoroughly assessing the patient’s
comprehension and the need for a translator is vi-
tal. Every attempt must be made to provide a qual-
ified translator whether the translator is physically
present or available via a telephone translation
line. Family members as translators may not be
able to translate important terms needed in obtain-
ing informed consent or education. Furthermore,
caregivers must provide written education mate-
rials for the patient to take home. Many concepts
are not easily translated, and it is imperative to
have a fluent translator translate the written
word into the targeted language.
11
An estimated 40 different languages are spoken by
the patients who use the services at one Midwest
community hospital. Managing multiple languages
and cultures has proven to be a challenge. The hos-
pital intranet offers resources for many of the cul-
tures including common practices, values, and
15. beliefs. Another unique attribute for this hospital
is the diverse nursing population. In the surgical
arena, every effort is made to pair similar culture/
language of the patient to the health care provider.
This luxury of a diverse nursing population is not
common for many facilities, creating a need to
rely on telephone language lines or hospital-
employed interpreters.
Madeleine Leininger’s theory of cultural care diver-
sity and universality defines culture as a guide
whereby the individual’s thinking, as well as his de-
cisions and actions, is patterned and usually passed
on from one generation to another.
12
A person
uses culture as a framework in viewing the world,
including health and the need for health care. Be-
cause patients can feel a sense of losing control,
they have a tendency to hold onto family beliefs
16. when they become ill. Successful teaching plans
are congruent with patient and family values.
4
Nursing care that incorporates cultural values
and practices can be positively related to patient
satisfaction, and patient compliance to treatment
will be greater. Conflict will result if nursing care
is in discord with the patient’s belief systems.
Knowing one’s patient is important for delivery of
care. A recent Swahili refugee was admitted to
have a cholecystectomy. She had been treated
with tribal medicine, which resulted in several
334 LINDA BEAGLEY
healed burn scars on her abdomen. Arousing from
anesthesia, the patient relayed through her inter-
preter that she wanted to see what was removed
during surgery. The nurse tried to explain that
the patient’s gallbladder had been removed and
sent to pathology. The patient continued to insist
17. that she needed to see the gallbladder. For this pa-
tient, it was imperative to visualize the gallbladder
to confirm that she was healed from her illness.
The nurse recognized the needs of the patient,
contacted the surgeon, and between the two of
them, they were able to have the patient see her
gallbladder through pictures taken during surgery.
Another example of the importance of cultural
awareness is demonstrated in the story below.
The diabetic educator consults with patients
who have gestational diabetes frequently in the
clinic. A Muslim patient and her husband were
scheduled for education. In this patient’s culture,
the educator was not permitted to address the
patient directly and was to speak only to the
husband. To acknowledge the patient’s cultural
beliefs, the educator instructed the husband,
who then instructed the patient in her presence.
The educator used several different teaching tech-
18. niques to quantify that the patient could safely ad-
minister insulin to herself.
In the American culture, the patient is the key deci-
sion maker in health care.
13
The patient may consult
with other family members, but ultimately, the pa-
tient makes the final decision.
14
Traditionally, Amer-
ican families have been defined as having a mother,
father, and child/children. Familial hierarchy can be
different for some cultures. How is the ‘‘family’’ de-
fined for this patient? Is it the immediate nuclear
family or the family that may include extended fam-
ily members,closefriends,or neighbors?Identifying
who isthe healthcare decision makerfor the patient
is important.
4,13
For some cultures, the decision
maker is the head of the household or the entire
19. extended family. All key players must be involved
in any decisions because they will either reinforce
or block health care behaviors.
The nurse must be aware of both verbal and non-
verbal communication behaviors. There are vast
differences in culturally defined communication
behaviors. Before discussion of personal informa-
tion, it is important to understand cultural prac-
tices related to nonverbal communication during
conversation, communication practices related to
the opposite gender, and cultural practices of so-
cial conversation.
4
Gender-specific topics could
be taboo for some cultures. For some, direct eye
contact is a sign of disrespect. Be aware of cultures
in which disagreement is perceived as impolite-
ness. The patient may be agreeing with what the
health provider is saying purely out of civility
rather than out of agreement.
20. 13,15
Physical and Environmental Barriers
Physiological factors play a role in how the patient is
ableto process health information. As a person ages,
visual clarity and auditory acuity will decrease, mak-
ing it difficult for the person to receive information.
Many times, a patient may refuse to wear corrective
devices. Altered mental capacity because of patho-
logic disease processes, such as Alzheimer disease,
or pharmacologic interventions, such as medica-
tions, can create a barrier for effective teaching.
Increasedagingmay causedeclineincognitive capa-
bilities in processing information, memory, and
comprehending abstractions.
16
As the adult ages,
the ability to reason and process information occurs
at a slower rate and reaction or response time in-
creases significantly after the age 65. Managing
multiple messages simultaneously is harder to do.
21. Short-term memory loss and the quantity of new
information may limit the length of the teaching
session and amount of information given. The
capacity to draw conclusions from inference
decreases in the older adult. Vague terms of
‘‘adequate,’’ ‘‘several times a day,’’ and ‘‘often’’ can
have multiple meanings. Directions should be spe-
cific to time and order with quantities defined.
Physical conditions can limit mobility and the pa-
tient’s ability to sit and be receptive to learning.
Many times, patients seek out health care be-
cause of pain or not feeling well. Uncontrolled
pain will block the patient’s ability to receive in-
formation. Anticipation, anxiety, and fear are all
contributing factors in diminishing reception of
knowledge. In the perianesthesia area, pain and
anxiety are obstacles that must be identified
and controlled for the patient to comprehend
information.
22. Because of busy schedules, environmental barriers
are challenging at times. Poor lighting, noise levels,
and room temperatures can inhibit the learning
Table 3. Learning Styles With Teaching
Strategies
Learn Styles Teaching Strategies
Visual Visual material
Handouts—easy to read
Variety of technology—computers,
overhead, video, TV, Internet
Auditory Rephrase key points
Vary speed, volume, and pitch
Write down key points
Positioned to hear the message clearly
Use multimedia—tapes, music
Kinesthetic Frequent breaks to move around
Learner writes own notes
Provide tactile activities
23. Product samples
EDUCATING PATIENTS 335
process. These barriers are difficult to control be-
cause of capped thermostats and controlled light-
ing. Noise levels are under careful consideration
because of the complaints of patients who have
not been able to rest because of noise while hospi-
talized. Hospitals have responded by instituting
quiet times during the day. Physical space for the
health care professional to share information
with the patient that is private, quiet, and with
minimal distractions can be at a premium,
although necessary for effective learning. Lastly,
time to devote to adequate teaching is a large bar-
rier in today’s health care environment. Profes-
sionals are asked to do more with less, including
time. Patients’ length of stay has shortened be-
cause of many factors, giving the nurse less time
with the patient to accomplish important teaching
24. elements.
Learning Styles
Besides understanding barriers that impact the re-
ception of education, the nurse must be aware of
how an individual learns. Learning patterns are de-
veloped as a child and the ‘‘learner’’discovers what
works best for his or her individual learning style.
Assessment of the patient is essential for effective
teaching, which may require more than one learn-
ing style for comprehension. Learning patterns in-
clude visual, auditory, and kinesthetic.
17
A visual
learner prefers to see what he or she is learning.
Pictures and images help the learner understand
ideas and information better than an explanation.
The auditory learner needs to hear the message
or instructions being given. This type of learner
wants to be talked through a process rather than
reading about it first. The kinesthetic learner
25. does not like lecture or discussion, preferring the
movement of the skill or task. Demonstration
and return demonstration works best with kines-
thetic learners.
17,18
Once the learning style is established, the nurse
adapts the teaching materials to the preferred
style. For the visual learner, the nurse will have ma-
terials for the patient to read or watch. The infor-
mation should be well organized, interesting,
appealing, and easy to read. With today’s advance-
ment of technology, there are many choices to of-
fer the visual learner, including computers, live
video feeds, close circuit television, photography,
and the Internet.
For the auditory learner, the nurse should rephrase
important points and questions in several different
ways to communicate the intended message. Vary-
ing the speed, volume, and pitch helps create an
26. interesting aural texture. An environment where
the patient and family can hear the message is im-
portant while encouraging the patient to write key
elements. A quiet space, preferably with the ability
to close the door along with minimal distractions,
assists the teacher to maximum the learning for an
auditory learner. To assist the auditory learner, in-
corporate multimedia of sounds, music, or speech.
Kinesthetic learners prefer frequent breaks so that
they can move around. The nurse should encour-
age the patient to take notes while providing tacti-
cal and hands-on activities. Providing samples
will allow the kinesthetic learner to practice
what he or she is learning, verifying comprehen-
sion through return demonstration. Table 3 sum-
maries learning styles with teaching strategies.
In the perianesthesia arena, more than one type of
teaching strategy may be necessary to successfully
deliver the message and establish comprehension.
27. For example, the follow-up telephone call was indi-
cating negative outcomes for several patients who
were to remove their urinary catheter at home. The
patient teaching before going home for this patient
population had become labor intensive, yet urinary
catheters were still being removed without deflat-
ing the catheter balloon, causing harm to the
patient and unhappy surgeons. Brainstorming,
336 LINDA BEAGLEY
a group of nurses looked to see how those in the
unit could improve the education process and out-
comes. The result was to continue to demonstrate
to the patient and significant other how to deflate
the balloon and remove the catheter. A return dem-
onstration was verified by both the patient and the
family member, each practicing using the syringe
and inserting it into the catheter port (without re-
moving the catheter). The department also devel-
28. oped a step-by-step handout with pictures for the
patient to take home. All three learning styles
were instituted to ensure a positive change of no
longer having patients remove the urinary device
with the balloon intact.
Teaching Methodologies
Teaching methodologies are multiple, and not all
will work in the perianesthesia setting. The most
common method is lecture, in which the presenter
gives information to the learner and learning is pas-
sive. Discussion allows for participation and for
the ability of the learner to ask and answer ques-
tions and share feelings. Demonstration is a useful
technique using both psychomotor and social
skills of the learner. In health care, demonstration
with return demonstration is commonly used
when a new technique or skill is to be learned by
the patient. An example of demonstration was the
urinary catheter instructions and patient demon-
stration previously mentioned.
29. Another common method of teaching is the use of
printed instructions. Printed health care informa-
tion should avoid technical language: use short
simple sentences and write at a level that most pa-
tients will understand.
4
The recommendation for
written instructions is that they be at the fifth
grade level. Avoidance of glossy paper and small
fonts also assists the learner.
The Internet can be a friend or foe when obtaining
health care information. Hospitals are setting up
Web sites for patients to obtain information. In
one pre-surgical testing department, the nurse
gives the scheduled surgical patient a Web site
where he or she can learn more about anesthesia
before coming to the hospital. Health care profes-
sionals also need to establish that the patient is ob-
taining reliable information on the Internet and
steer the patient to government and academic sites
that are proven to be more trustworthy.
30. 19
Inpa-
tients can watch health-related stations on their
televisions.
11
On the obstetric unit, patients can
access the television to learn about a variety of is-
sues related to the mother and care of the new
baby. The disadvantage of watching a television
station or already-taped segment is the inability
to ask and have questions answered immediately.
The nurse must be diligent in following up with
the patient to answer questions and reinforce the
teachings from the video.
Conclusion
For effective delivery of health information and ed-
ucation, the nurse must be aware of the barriers
that can impede the patient’s ability and readiness
to learn. Awareness of the potential barriers of lit-
eracy, culture, language, and physiological factors
will help the nurse determine what tools he or
31. she may need to assist in the delivery of informa-
tion. Awareness of one’s biases and prejudices
and overcoming them will assist in the education
process. The nurse assesses the patient’s under-
standing by looking at both verbal and nonverbal
cues that the patient is displaying. Using more
than one way of delivering the message will pro-
mote the patient’s learning. A family member pres-
ent during key moments will assist and help the
patient to remember the information. The astute
nurse will be more successful in overcoming bar-
riers if she or he is aware of patient’s needs and
areas where additional assistance is needed.
References
1. Knowles M. Andragogy: An emerging technology for adult
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2. Smith MK. Malcolm Knowles, informal adult education,
self-direction and andragogy, the encyclopedia of informal
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32. Accessed May 9, 2011.
3. U.S. Department of Health and Human Services. Literacy
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November 11, 2008.
http://www.infed.org/thinkers/et-knowl.htm
http://www.ahrq.gov
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National Standards for Culturally and Linguistically
Appropriate
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2010.
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14. Galanti G. Applying cultural competence to peri-
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http://nnlm.gov/outreach/consumer/hlthlit.html#A1
http://nnlm.gov/outreach/consumer/hlthlit.html#A1
http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/200
8_Documents/OA_2008.pdf
http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/200
8_Documents/OA_2008.pdf
37. • What: Teaching medication self-administration in home care
typically involves
educating and verifying that the patient understands
–the name of the medication, its mechanism of action, and what
it is used for
–correct dose
–correct timing of administration
–correct route of administration (e.g., oral or via subcutaneous
injection) and the proper
technique for self-administering the drug
–potential adverse effects and potential interactions with other
medication, food, and
supplements
–appropriate storage
–the importance of communicating information about
medication that is currently being
taken to healthcare clinicians, including both prescription and
over-the-counter (OTC)
medications
• How: A variety of teaching/learning and motivational
activities (e.g., face-to-face
instruction, telephone communication, written materials,
computer-mediated programs)
can be utilized to support patients and family members in
learning about medication
self-administration
–Combined strategies (e.g., face-to-face communication and
providing a written
pamphlet) have been shown to be more beneficial than verbal
instruction only
38. –For patients with a complex medication regimen, offering
information in more than one
session allows the patient to process smaller amounts of
information and avoid feeling
overloaded with information
• Where: Teaching about medication self-administration in
home care occurs in the home
environment. In some cases, teaching might begin in an
ambulatory care setting (e.g.,
the treating clinician’s office) or prior to discharge from the
hospital or a long-term care
facility
–Patients should receive consistent educational information in
all healthcare settings and
in the home throughout the course of patient care
• Who: Patient teaching about medication self-administration in
home care is provided by
healthcare professionals (e.g., registered nurses, pharmacists,
physicians) and should not
be delegated to assistive staff members
What Is the Desired Outcome of Teaching Medication Self-
Administration in the Home?
› Education about medication self-administration can empower
patients and allow them to
• understand the name, dose, route, timing, and purpose of each
prescribed medicine
• build confidence and skills necessary for successful
39. medication self-administration (e.g., filling pill organizers,
drawing up
insulin, using safe injection techniques, properly disposing of
syringes, using aerosol delivery systems correctly, using cues
to promote proper timing of medications, properly storing
medication)
• observe for adverse effects of medication when taken with
specific other medications, foods, or supplements and seek
medical assistance as needed
• engage in lifestyle changes to decrease risk for complications
(e.g., maintaining a consistent intake of vitamin K when
taking warfarin, regularly checking EPINEPHrine expiration
dates, wearing a medical alert bracelet when taking high-risk
medications)
• recognize the importance of communicating information about
medications that are currently being taken, including
prescription and OTC medications, to healthcare professionals
and participate in shared decision making about medication
self-administration
• cope with the psychosocial and emotional aspects of having an
illness that requires medication and adhering to a prescribed
medication regimen
Why Is Teaching Medication Self-Administration Important in
Home Care?
› Teaching home care patients how to correctly take their own
medications helps to promote safe, cost-effective delivery of
medications; self-administrationof medications is an important
component of self-care
› Errors in medication self-administration can lead to decreased
symptom control, increased risk for severe health issues, and a
40. greater number of emergency department visits,
hospitalizations, and nursing home placement, and can
significantly increase
healthcare costs for preventable complications
› Patient education is required by The Joint Commission (TJC),
and medication safety is an integral part of TJC Home
Care National Patient Safety Goals. The home care nurse is
required to provide patients with written information on
medications that are being taken in the home care setting and to
educate about their role in providing information about
the medications they are taking (e.g., giving a list of current
medications to the treating clinician, serially updating the list,
carrying medication information in the event of an emergency)
(TJC, 2018)
Facts and Figures
› Children are at increased risk for having problems with
managing medication. In a study of children receiving
medications
for asthma,the following were the most common areas of risk
(Wilson et al., 2015):
• Responsibility in medication administration (i.e., the degree to
which the patient takes his/her medication); researchers
reported that about 39% of children take their medication “all of
the time,” 7% take their medication “quite a bit of the
time,” and 46% are at high risk for not taking responsibility for
taking their medication
• Wellbeing of the child’s caregiver, particularly related to
coping and stress management
• The child’s well-being, including his/her behaviors and
emotions
41. • Medication adherence
› A multidisciplinary work group at Johns Hopkins Health
System developed and implemented a post discharge home-
based,
pharmacist-provided medication management service. This
service not only enhanced continuity from hospital to home, it
ensured that pharmacists identified and resolved medication
discrepancies, educated patients about their medications, and
provided primary clinicians and community pharmacists with a
complete and reconciled medication list. While prevention of
readmissions was not a targeted outcome of the project, only 8%
of patients who received the service were readmitted within
30 days. On average, the readmission rate for similar patients in
the same hospital was 16–17% (Pherson et al., 2014)
› Improper use of dry powder inhalers can result in an
insufficient amount of the drug being deposited in the lungs. In
a study
of patients with chronic obstructive pulmonary disease,
educational handouts were given to help patients who were
already
using inhalers. Researchers found that the handouts alone were
effective in improving inhaler technique; vision and health
literacy did not impact on the patients’ inabilities to learn
proper technique (Alsomali et al., 2017)
› Prescription opioid abuse is epidemic. Opioid diversion to
family members and friends is a major source of abused
prescription opioids. Nurses play a key role in reversing this
opioid abuse by providing essential anticipatory guidance each
time a patient receives a medication prescription (Manworren et
al., 2015)
› In Spain, researchers studied 45 patients with infective
endocarditis (IE) who self-administered parenteral antibiotics in
42. a
“hospital-in-home” (HIH) environment. During each self-
administration session, a nurse or treating clinician briefly
visited
the patient. The rate of inpatient readmission was 12.5% and no
patients died while in the HIH program (Pajarón et al., 2015)
› In a study of 23,614 patient records, researchers concluded
that when patients with a high risk for adverse reactions and
a slow immunotherapy buildup phase were excluded, systemic
reaction (SR) rates during home immunotherapy were
significantly lower than SR rates during office-
basedimmunotherapy (Schaffer et al., 2015)
› When prescribing oral cancer agents, clinicians must be aware
of factors that affect adherence; these include side effects,
forgetfulness, beliefs about medication necessity, established
routines for medication self-administration, social support,
ability to fit medications in lifestyle, cost, and medication
knowledge. Depression and negative expectations can also
negatively influence adherence (Irwin et al., 2015)
› In a qualitative study of mental healthcare professionals,
researchers found that although health professionals recognize
that
treatment adherence is a major issue, they frequently do not use
evidence-based interventions to address the problem. The
researchers concluded that it is necessary for clinicians to
challenge their own pre-existing beliefs about treatment
adherence
to more effectively help patients manage medications (Brown et
al., 2015)
What You Need to Know Before Teaching a Patient about
43. Medication Self-
Administration in the Home Care Setting
› Prior to initiating medication self-administration, the nurse
must carefully assess the patient’s ability to safely self-
administer
medication. This is often determined using subjective judgment,
including subjectively judging the patient’s knowledge
of each medication, cognitive ability to follow instructions,
ability to read medication labels and package inserts, manual
dexterity needed to administer the prescribed medications,
ability to administer each medication, and ability to recognize
adverse effects and report them to the treating clinician
• The Self-Administration of Medication (SAM) tool used to
assess a patient’s ability to self-administer medications offers
consistency in evaluation, can be completed in a short time, and
is more objective than the perceptions of healthcare
clinicians. Other similar tools are available
• Assessing medication self-administration abilities in stroke
patients is particularly important. Stroke patients might not be
aware of their cognitive deficits and can overestimate their
competence related to medication self-administration
› TJC’s focus on medication safety requires that home care
nurses accurately and completely reconcile medications in
the home environment. This process includes comparing current
and newly ordered medicines, communicating about
medications with the next clinician who will provide patient
care, giving a written list of the patient’s medicines to the
patient and family,and educating the patient and family about
the list (TJC, 2018). To improve medication safety, TJC
suggests that patients should adopt the following:
• Properly discarding old or outdated medications (for
information about safe disposal of medicines, refer to the
44. U.S. Food and Drug Administration (FDA) Web site at
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/
BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeD
isposalofMedicines/default.htm)
• Bringing all prescription and OTC medicines and supplements
to physician office visits or to a local pharmacy for review
• Carrying a list of the names and numbers of healthcare
providers and pharmacies used
• Carrying a list of all prescription medications and OTC
medications and supplements that are currently being taken with
dosages, special instructions, and known allergies
› Patients should be taught basic information about drug safety
in the home such as the importance of
• keeping drugs in their original, labeled containers
• finishing a prescribed medication (e.g., an antibiotic) unless
instructed otherwise
• not saving drugs for future use and not giving them to another
person
• keeping drugs out of reach of children
• storing medicines at proper temperatures (e.g., refrigerate as
needed, store in a clean and dry area, keep away from extreme
temperatures)
• reading medication labels carefully and following all
instructions
• being aware of look-alike, sound-alike drugs
› Home care patients with a complex medication regimen should
be taught strategies for organizing their medications
and establishing a system of cues for taking them at specific
times (e.g., posting a schedule on the refrigerator; creating
a medication calendar with pictures of the pills; having someone
45. send text reminders to take medicines; using a
self-administration medication documentation sheet to keep
track of administration; using pill boxes, egg cartons, or
cupcake
tins to organize medications; using color-coded sections to
designate specific days and times)
› Common concerns about oral medication self-administration
include adhering to the routine of taking multiple pills several
times a day, coping with having severe or constant adverse
effects, and coping with medication-relatedfinancial difficulty
› Older adults often self-administer medications despite being at
increased risk for having problems managing their
medication. A common mistake is often omission of a
prescribed medication
› Medication administration routes that are used in the
outpatient setting or in the home care setting each have their
own risks
and benefits; for example:
• Outpatient parenteral antibiotic therapy (OPAT)was
introduced in the U.S. in the 1970s. OPAT is currently practiced
worldwide and is a safe and effective option for carefully
selected patients
• Home self-administered allergen immunotherapy, which was
previously considered controversial, is now thought to be a
safe option for carefully preselected patients
› Although oral medication administration is the easiest, most
common method, it is contraindicated in patients who have
gastrointestinal (GI) abnormalities, including patients with a
46. nasogastric tube (NGT), gastrostomy tube, or poor gag reflux
and patients who are unable to swallow or are unresponsive
• Home care patients taking oral medicines need to be cautioned
about drugs that cause gastrointestinal distress
• Patients taking sublingual medicines should be reminded not
to swallow them, and patients taking buccal medications
should be taught to allow the medicine to dissolve against the
mucous membrane of the cheek and then swallow the saliva
› It is common for patients with asthma to use up to three
metered-doseinhalers (MDIs) daily, and each meter requires
performing multiple steps for safe and accurate use. Most
patients do not use their MDIs correctly and many healthcare
professionals lack knowledge about proper technique. Spacer
devices can be used with certain MDIs to improve technique
and allow the patient to inhale for a longer period. Dry-powder
inhalers are recommended as an effective alternative.
Although variations exist among types of MDIs, patients should
be educated to generally perform the following steps:
• Remove the cap and hold inhaler upright
• Shake the inhaler
• Breathe out slowly and completely
• Place the inhaler 1–2 inches away from the mouth or in the
mouth
• Start to breathe in slowly and press the lever as indicated on
the inhaler
• Inhale slowly over a period of 3–5 seconds
• Hold breath at full inhalation for 10 seconds
• Exhale
• Repeat if indicated after 1 minute
• Rinse mouth with water if using an inhaled steroid
› During the past decade, self-administration and safe handling
and disposal of oral chemotherapy agents by patients with
cancer have been areas of concern, yet not all clinics, hospitals,
47. and healthcare agencies have implemented standard
protocols for teaching patients and family members about these
medications
• To help patients more effectively manage self-administration
of prescribed oral chemotherapy agents, refer to the Oncology
Nursing Society oral adherence toolkit at
https://www.ons.org/practice-resources/toolkits/oral-adherence
• Education alone is not enough to promote adherence to oral
medication regimens for cancer. Adherence tools, technologies,
and reminder aids can be used to assist patients in adhering to
an oral regimen
› According to the American Association of Poison Control
Centers (www.aapcc.org),the most common poisons are found
in medications (e.g., pain medicine, including OTC agents,
prescribed pain relievers, and illicit drugs; sedatives, hypnotics,
and antipsychotics; antidepressants; and cardiovascular drugs).
Recent online alerts caution readers to beware of potentially
dangerous health effects after using synthetic marijuana and
liquid nicotine. Lack of patient concern about the appropriate
use of medication (e.g., saving medication for future personal
use to avoid having to see a healthcare clinician,giving
prescribed medication to others, and taking more medication
than prescribed in the hope that it will be curative) can result in
adverse reactions, organ failure, and death
› Although certain educational interventions (e.g., providing
reading materials, engaging the patient in self-care training)
are used most commonly in clinical practice to teach patients
about medications and self-administration, counseling and
behavioral interventions have been found to be more effective
in enhancing medication adherence
› Evidence of the effectiveness of specific medication
48. adherence-enhancinginterventions is limited. Researchers warn
that
findings should be interpreted with caution
• The strongest evidence-based support for improving
medication adherence involves policy-level interventions that
promote
reduced out-of-pocket expenses, case management, and
educational interventions
• Among patients with different clinical conditions, medication
adherence is highly variable. In a comparative study of the
effectiveness of interventions, the greatest opportunities for
medication adherence improvement were seen in patients with
asthma, depression, or hypertension
› The most successful strategies for teaching patients about
medication self-administration are individualized educational
interventions
• Patient education and teaching tools (e.g., handouts, books,
videos) should be tailored to the patient’s specific needs and
priorities
• Visually oriented informational handouts (i.e., those with
diagrams and limited wording) should be patient-friendly and
easy to read
• All teaching should be patient-centered and evidence-based
–Home care patients should be given detailed and accurate
medication information; they should be instructed to avoid the
use of advertised medications and products unless they have
been reviewed by healthcare professionals
49. • Educational information should be delivered in a culturally
sensitive manner and in a language and at a level that is easily
understood by the patient and family
• Professional certified medical interpreters, either in person or
via phone, should be used when there are language barriers
• Simple, nonmedical language should be used for all patients
and families, but especially when low literacy levels are
assessed
› Preliminary steps that should be performed prior to teaching a
patient about medication self-administration in the home care
setting include the following:
• Become knowledgeable about the requirements of TJC related
to patient education
• Review facility/agency protocols specific to patient education,
particularly about medication self-administration practices
in the home care setting
• Become familiar with facility/agency practices for teaching a
patient about medication self-administration
• Identify acceptable patient teaching resources that are
available onsite and via the Internet
› Verify availability of supplies prior to initiating the
educational session (noting that supplies will vary based on
patient
assessment, below). Supplies can include
• a teaching guideline or documentation form outlining key
content areas
• printed and audiovisual materials about medication self-
administration procedures
• medication administration equipment (e.g., medications in
their original containers, a pill organizer, syringes, alcohol
50. wipes, MDIs)
• information about Internet and community resources that are
available to assist patients with self-administration of
medication and with proper storage and disposal of medications
• information on how to contact members of the healthcare team
with questions or concerns
How to Teach a Patient about Medication Self-Administration in
the Home Care
Setting
› Perform hand hygiene
› Don personal protective equipment (PPE), if indicated
› Identify the patient per facility protocol
› Establish privacy
› Introduce self and explain planned education
› Assess the patient for
• readiness to learn
–Patients can be at different stages of readiness; it is important
to individualize your approach based on each individual
learner’s readiness
• preferred learning style
–Individuals are auditory, visual, or tactile learners, and learn
by hearing (e.g., listening to other patients talk about the
challenges of managing the side effects of medications), by
seeing (e.g., observing the home care nurse draw up insulin),
and by doing (e.g., filling a pill organizer)
–To quickly identify one’s preferred learning style, have the
learner think back to the last time he or she learned something,
and ask, “How did you go about it?”
• patient-identified learning priorities
51. –When there is incongruence between the patient’s priorities
and the healthcare provider’s goals, all will need to explore
why the incongruence exists (e.g., when the patient being
treated with an antibiotic decides not to continue to take it
because he/she is feeling much better)
• learning barriers
–Barriers can include impaired memory or cognitive
difficulties; learning disabilities; physical limitations; language;
low
literacy; impaired hearing, sight, and/or speech; financial
issues; and cultural, psychosocial, and/or emotional concerns
- Patients with a low literacy level can have difficulty
calculating dosages and measuring liquids. In the home care
setting, the nurse has an ideal opportunity to observe what a
patient uses to measure a medication dose and how he/she
determines how much to take
- Cultural beliefs and practices should be carefully examined
because they can influence ideas about medication use
• learning needs and desires
–Many home care patients are preoccupied with the complexity
of their care and might need to be encouraged to learn
more about medication self-administration
› Plan for timely delivery of relevant information
• The plan for medication instruction should be comprehensive,
but tailored to meet the patient’s specific learning needs; it
should be divided into information segments that are scheduled
52. at intervals to avoid overwhelming the patient
–There should be clear delineation in the healthcare team of
who provides what information and at what time throughout
the course of patient care; for example,
- an acute care nurse provides the hospitalized patient with
written information about drugs, discusses the risks and
benefits of taking the drugs, helps him or her learn how to self-
administer the drugs, and emphasizes the importance of
timely and consistent use of the drugs
- at discharge to home, a pharmacist who fills prescriptions in
the community reinforces the medication instructions,
emphasizing the medication name, purpose, dose, route,
frequency, and potential adverse effects
- during a follow-up appointment, the home health nurse
reconciles the patient’s medications, assesses the patient’s use
of
the medications, listens to the patient’s concerns about the
drugs, and educates about the need to alter patient behavior
(e.g., eliminate alcohol consumption to avoid liver damage) and
change habits of self-administration as appropriate
• High-quality teaching tools (e.g., clear, concise drug
information sheet written at a 5th grade reading level; a DVD
about
the safe use of digoxin; a Website about the national Drug
Take-Back program for safe medication disposal) should be
identified in advance to support teaching and learning
–The assessment of the patient’s learning characteristics, along
with his/her clinical needs, should guide the selection of
appropriate teaching tools
• When appropriate, patient education should be scheduled when
53. family members or caregivers are available to support the
patient in learning
› Implement the patient education plan
• Discuss and set mutually achievable goals for learning about
medication self-administration with the patient
–Anticipate a planned approach to teaching and learning, but be
prepared to be flexible and individualize information based
on the patient’s changing needs and desires
• Emphasize the name, dose, route, timing, purpose, and adverse
effects of each medication, and educate about safety
concerns related to medication self-administration
–Make the education situation as realistic as possible; if
feasible, schedule home visits to coincide with the patient’s
medication self-administration times
–Allow sufficient time for the patient to practice skills and talk
about any concerns
–If the patient is not able to safely administer his/her
medication regimen, arrange for family members or other
caregivers
to support the patient as needed
• Promote collaborative partnerships between the patient and
members of the healthcare team to achieve the highest levels of
medication adherence
–Use open-ended requests that allow the patient to explain or
demonstrate and that enable the healthcare provider to verify
the patient’s understanding (e.g., “Tell me [or show me] how
you take your medication”)
–Ask specific questions about the patient’s medication regimen
54. (e.g., “What time do you take the medicine?”, “How many
pills do you take?”, “What is the name of this green pill?”)
–Observe facial expressions and other cues that indicate that the
patient does not understand the prescribed medication
regimen
• Use a variety of teaching and learning strategies for best
results
–Direct communications (e.g., face-to-face conversation,
telephone calls) are fundamental in helping patients learn about
medication self-administration
–Written materials (e.g., a booklet, fact sheets) have received
mixed reviews
- The effectiveness of print materials varies based on
comprehensibility, visual appeal, legibility, text style, size, and
layout
–Some computer-mediated medication programs have been
customized for older adults (e.g., with enlarged text size,
high color contrast between the text and the background, slower
animations to allow for processing information, extra
wide scroll bars). These programs allow the nurse to enter
patient-specific information (e.g., medication regimen, blood
pressure readings) so that the information can be tailored to
meet the patient’s specific learning needs; such programs can
be effective in reducing medication errors and increasing
adherence in older adults
–Internet resources are readily available to most patients,
55. although healthcare professionals disagree as to the value of
Internet information
- One strategy to enhance Internet use by patients is to provide
a list of relevant Websites that are thought to be accurate,
current, and understandable
› Evaluate the patient’s response to education
• Continually assess learning throughout the continuum of care
• Use a teach-back method to evaluate learner understanding
–Have the patient repeat medication information and/or
demonstrate medication self-administration while allowing the
educator to listen, observe, and clarify the information or skill
demonstration, as needed
–Remember that specific information is better recalled than
general information
• Use a self-efficacy (i.e., the extent to which a person …
NR305 Week 4 Patient Teaching Plan Grading Rubric
Criteria Ratings Pts
This
criterion is
linked to a
Learning
Outcome
Health
Topic (20
points)
56. Describe
in detail
why this is
an
important
topic for
patient
education.
Use
evidence
from the
textbook,
lesson or
an outside
scholarly
source to
support
your
rationale.
20.0 pts
Excellent
rationale for
the
importance
of the topic
and clearly
supported
by related
evidence
from text,
lesson or
outside
scholarly
57. source
18.0 pts
Good
rationale for
the need for
the
importance
of the topic
and
supported
by related
evidence
from text,
lesson, or
outside
scholarly
source
16.0 pts
Minimal
rational
e for
patient
educati
on on
the
topic
and
support
ed by
related
evidenc
e
62. characteri
stics.)
This
criterion is
linked to a
Learning
Outcome
Learning
Barriers
(20 points)
What are
some
potential
learning
barriers
for this
population
of
learners?
How can
you
address
these
learning
barriers in
your
Visual
Teaching
Tool
design?
67. in detail,
the setting
where you
will utilize
your
Visual
Teaching
Tool.
Include
details as
appropriat
e, such as
room or
table set
up,
20.0
pts
Exce
llent
desc
riptio
n of
setti
ng;
inclu
des
thor
ough
cons
idera
tion
of
how
72. This
criterion is
linked to a
Learning
Outcome
Learning
Objectives
(20 points)
Write
three
specific
learning
objectives
your visual
teaching
tool will
address.
20.0
pts
Lear
ning
obje
ctive
s
are
clea
r,
very
well-
writt
78. r
u
n
cl
e
a
r
n
k
This
criterion is
linked to a
Learning
Outcome
Evaluation
Plan (15
points)
Write a
paragraph
describing
how you
could
evaluate
whether
your visual
teaching
tool was
successful
95. deduction;
5 days late
= 31.25
0.0
pts
S
u
b
m
i
t
t
e
d
o
n
t
i
m
e
deduction;
6 days late
= 37.5
deduction;
7 days late
= 43.75
deduction;
Score of 0
if more than
96. 7 days late
Total Points: 125.0
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ms/8217886
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Chamberlain College of Nursing NR305 Health Assessment
Patient Teaching Plan
NOTE: Please do NOT remove any of the text on this form. Do
NOT use any other form but this one. Fill it in and submit in its
entirety to aid in its grading.
Your Name: Date:
Purpose: The purpose of this Patient Teaching Project is to
develop a patient teaching plan and create a visual teaching tool
aimed at promoting health and preventing disease for a
specified patient population.
Directions:
· This Teaching Plan is Part 1 of the Patient Teaching Project.
You will use this Patient Teaching Plan to create a Visual
Teaching Tool in Part 2 of this project.
Patient Teaching Plan
HEALTH TOPIC
ANSWER
State the topic you have selected for your Teaching Project.
(Please select from the list provided in the Teaching Project
97. guidelines located in Module 4.)
Describe in detail why this is an important topic for patient
education. Use evidence from the textbook, lesson or an outside
scholarly source to support your rationale.
POPULATION
ANSWER
Describe, in detail, the characteristics of the population you are
planning to teach with the Visual Teaching Tool.
BARRIERS
ANSWER
What are some potential learning barriers for this population of
learners?
(Barriers might be cultural, physical, educational, or
environmental. Refer to the assigned article in the project
guidelines for more information.)
Describe how you could develop your Visual Teaching Tool in a
98. way that will address these potential barriers.
SETTING
ANSWER
Where do you plan to utilize your Visual Teaching Tool?
(Examples: primary care clinic, health fair, school, etc…)
Will you be teaching one-on-one, in small groups, or to a large
crowd?
LEARNING OBJECTIVES
ANSWER
Write three specific learning objectives your visual teaching
tool will address.
Example:At the end of this education, the learner will be able to
list 3 benefits of regular physical activity.
1.
2.
3.
EVALUATION
ANSWER
Write a paragraph describing how you could evaluate whether
your visual teaching tool was successful and met the learning
objectives. Consider the population’s abilities and the setting.
REFERENCES
ANSWER
99. List any references used to create this Teaching Plan in APA
format.
(Hanging indent not required.)
Remember to also use in-text citations within this document,
when appropriate (Author, year).
NR305_W4_Patient Teaching Plan Form Rev. 8/2018
KC 1
Chamberlain College of Nursing
NR
305
Health Assessment
NR305_
W4_Patient Teaching Plan Form
Rev. 8/2018
KC
1
Patient Teaching Plan
100. NOTE: Please do NOT remove any of the text on this form.
Do NOT use any other form but this one.
Fill it
in and submit in its entirety to aid in its grading.
Your
Name:
Date:
Purpose:
The purpose of this Patient Teaching Project is to
develop a patient teaching plan and
create
a
visual teaching tool
aimed at promoting
health and preventing disease
for a specified patient
population.
Directions
:
·
This Teaching Pl
an is Part 1 of the Patient Teaching Project.
You will use this Patient Teaching
Plan to create a Visual Teaching Tool in Part 2 of this project.
101. Patient Teaching Plan
HEALTH TOPIC
ANSWER
State the topic you have selected
for your Teaching Project.
(Please select from the list
provided
in the Teaching Project guidelines
located
in Module 4.)
Describe in detail why this is an
important topic for patient
education. Use evidence from the
textbook, lesson or an outside
scholarly source to support your
rationale.
102. Chamberlain College of Nursing NR305 Health Assessment
NR305_W4_Patient Teaching Plan Form Rev. 8/2018
KC 1
Patient Teaching Plan
NOTE: Please do NOT remove any of the text on this form. Do
NOT use any other form but this one. Fill it
in and submit in its entirety to aid in its grading.
Your Name: Date:
Purpose: The purpose of this Patient Teaching Project is to
develop a patient teaching plan and create a
visual teaching tool aimed at promoting health and preventing
disease for a specified patient
population.
Directions:
You will use this Patient Teaching
Plan to create a Visual Teaching Tool in Part 2 of this project.
Patient Teaching Plan
HEALTH TOPIC ANSWER
State the topic you have selected
for your Teaching Project.
(Please select from the list provided
in the Teaching Project guidelines
located in Module 4.)
Describe in detail why this is an
103. important topic for patient
education. Use evidence from the
textbook, lesson or an outside
scholarly source to support your
rationale.
Week 3 Discussion: Failure of Democracy and
the Rise of Totalitarianism
1
1 unread reply.
1
1 reply.
Required Resources
Read/review the following resources for this activity:
● Textbook: Chapter 4, 5
● Lesson
● Minimum of 1 scholarly source (in addition to the textbook)
104. Initial Post Instructions
During the 1930s, much of the world seemed to give up on their
hope for a democratic
solution to their problems and instead turned to totalitarianism,
both in Europe and in
Asia.
For the initial post, select and address one of the following:
● Germany/Hitler
● USSR/Stalin
● Japan/Tojo
Address the following questions for your selection:
● What effects did the history, politics, and economies of those
areas play in their
decisions to turn to totalitarianism?
● What role did the Great Depression in the United States play
in their plight?
Follow-Up Post Instructions
Respond to at least two peers or one peer and the instructor. At
least one of your
responses should be to a peer who chose an option different
from yours. Further the
dialogue by providing more information and clarification.
Writing Requirements
● Minimum of 3 posts (1 initial & 2 follow-up)
105. ● Minimum of 2 sources cited (assigned readings/online lessons
and an outside
source)
● APA format for in-text citations and list of references