Chat with us, powered by LiveChat 1- Discuss the three phases in the development of organized health care. 2- How does education pro - Study Help
  

1- Discuss the three phases in the development of organized health care.
 2-  How does education process look like nursing process?
 3- What are the barriers to teaching and obstacles to learning? Give examples from your experience.

Nurse as
Educator

Principles of Teaching and
Learning for Nursing Practice

FIFTH EDITION

© Helaine Weide/Moment/Getty

Nurse as Educator: Principles of Teaching and Learning for Nursing Practice, Fifth Edition drives
comprehension through various strategies that meet the learning needs of students, while also gen-
erating enthusiasm about the topic. This interactive approach addresses different learning styles,
making this the ideal text to ensure mastery of key concepts. The pedagogical aids that appear in
most chapters include the following:

The Pedagogy

Chapter Highlights Chapter high-
lights provide a quick-look over-
view of the content presented in
each chapter.

Key Terms Found in a list at the be-
ginning of each chapter, these terms
will create an expanded vocabulary.

© Helaine Weide/Moment/Getty

Overview of Education
in Health Care
Susan B. Bastable
Kattiria M. Gonzalez

CHAPTER 1

CHAPTER HIGHLIGHTS

■ Historical Foundations for Patient Education in Health Care
■ The Evolution of the Teaching Role of Nurses
■ Social, Economic, and Political Trends Affecting Health Care
■ Purposes, Goals, and Benefits of Patient and Nursing Staff/Student Education
■ The Education Process Defined
■ The Contemporary Role of the Nurse as Educator

• Nursing Education Transformation
• Patient Engagement
• Quality and Safety Education in Nursing
• The Institute of Medicine Report: The Future of Nursing

■ Barriers to Teaching and Obstacles to Learning
• Factors Affecting the Ability to Teach
• Factors Affecting the Ability to Learn

■ Questions to Be Asked About Teaching and Learning
■ State of the Evidence

KEY TERMS

education process
teaching/instruction
learning

patient education
staff education

barriers to teaching
obstacles to learning

3

Objectives These learning objectives
provide instructors and students with a
snapshot of the key information they will
encounter in each chapter. They serve as
a checklist to help guide and focus study.

Evaluation is defined as a systematic pro-cess that judges the worth or value of some-thing—in this case, teaching and learning.
Evaluation can provide evidence that what nurses
do as educators makes a value-added difference
in the care they provide.

Early consideration of evaluation has never
been more critical than in today’s healthcare en-
vironment, which demands that “best” practice
be based on evidence. Crucial decisions regard-
ing learners rest on the outcomes of learning.
Can the patient go home? Is the nurse provid-
ing competent care? If education is to be jus-
tified as a value-added activity, the process of
education must be measurably efficient and
must be measurably linked to education out-
comes. The outcomes of education, both for

the learner and for the organization, must be
measurably effective.

For example, the importance of evaluating
patient education is essential (London, 2009).
Patients must be educated about their health
needs and how to manage their own care so that
patient outcomes are improved and healthcare
costs are decreased (Institute for Healthcare Im-
provement, 2012; Schaefer, Miller, Goldstein, &
Simmons, 2009). Preparing patients for safe dis-
charge from hospitals or from home care must
be efficient so that the time patients are under
the supervision of nurses is reduced, and it also
must be effective in preventing unplanned read-
missions (Stevens, 2015). Monitoring the hos-
pital return rates of patients is not a new idea
as a method to evaluate effectiveness of patient

OBJECTIVES

After completing this chapter, the reader will be able to

1. Define the term evaluation .
2. Discuss the relationships among evaluation, evidence-based practice, and practice-based evidence.
3. Describe the differences between the terms evaluation and assessment.
4. Identify the purposes of evaluation.
5. Distinguish between five basic types of evaluation: process, content, outcome, impact, and program.
6. Discuss characteristics of various models of evaluation.
7. Explain the similarities and differences between evaluation and research.
8. List the major barriers to evaluation.
9. Examine methods for conducting an evaluation.

10. Explain the variables that must be considered in selecting appropriate evaluation instruments
for the collection of different types of data.

11. Identify guidelines for reporting the results of evaluation.
12. Describe the strength of the current evidence base for evaluation of patient and nursing staff

education.

KEY TERMS

evaluation
evidence-based practice

(EBP)
external evidence
internal evidence
practice-based evidence

assessment
process evaluation

(formative evaluation)
content evaluation
outcome evaluation

(summative evaluation)

impact evaluation
total program evaluation
evaluation research
reflective practice

596 Chapter 14 Evaluation in Healthcare Education

Review Questions Review key con-
cepts from your reading with these
exercises at the end of each chapter.

The importance of evaluation as internal
evidence has gained even greater momentum
with the movement toward EBP. Perhaps the
most important point to remember is this: Each
aspect of the evaluation process is important,
but all these considerations are meaningless if
the results of evaluation are not used to guide
future action in planning and carrying out ed-
ucational interventions.

Review Questions
1. How is the term evaluation defined?
2. How does the process of evaluation differ

from the process of assessment?
3. How is evidence-based practice (EBP)

related to evaluation?
4. How does internal evidence differ from

external evidence?
5. What is the first and most important step

in planning any evaluation?
6. What are the five basic components

included in determining the focus of an
evaluation?

7. How does formative evaluation differ
from summative evaluation, and what is
another name for each of these two types
of evaluation?

8. What are the five basic types (levels) of eval-
uation, in order from simple to com plex,
as identified in Abruzzese’s RSA evalua-
tion model?

9. What is the purpose of each type (level)
of evaluation as described by Abruzzese
in her RSA evaluation model?

10. Which data collection methods can be
used in conducting an evaluation of
educational interventions?

11. What are the three major barriers to
conducting an evaluation?

12. When and why should a pilot test be
conducted prior to implementing a full
evaluation?

13. What are three guidelines to follow in
reporting the results of an evaluation?

results. Process, content, and outcome evalu-
ations also are more frequently conducted as
research projects, however, underscoring the
importance of evidence as a basis for making
practice decisions. Sinclair, Kable, Levett-Jones,
and Booth (2016) conducted a systematic re-
view of randomized clinical trials to determine
the effectiveness of e-learning programs on
health professionals’ behavior and patient out-
comes. After screening articles initially iden-
tified for review, the authors found 12 process
and outcome RCTs worthy of further appraisal
and 7 articles worthy of inclusion in the final
systematic review. This is just one example of
the increase in level of rigor in evaluations of
healthcare education.

▸ Summary
Conducting evaluations in healthcare educa-
tion involves gathering, summarizing, inter-
preting, and using data to determine the extent
to which an educational activity is efficient,
effective, and useful for those who participate
in that activity as learners, teachers, or sponsors.
Five types of evaluation were discussed in this
chapter: (1) process, (2) content, (3) outcome,
(4) impact, and (5) program evaluations. Each of
these types focuses on a specific purpose, scope,
and questions to be asked of an educational
activity or program to meet the needs of those
who ask for the evaluation or who can benefit
from its results. Each type of evaluation also re-
quires some level of available resources for the
evaluation to be conducted.

The number and variety of evaluation
models, designs, methods, and instruments are
growing exponentially as the importance of
evaluation becomes widely accepted in today’s
healthcare environment. Many guidelines, rules
of thumb, suggestions, and examples were in-
cluded in this chapter’s discussion of how a nurse
educator might go about selecting the most ap-
propriate model, design, methods, and instru-
ments for a certain type of evaluation.

627Review Questions

Case Studies Case studies encour-
age active learning and promote
critical thinking skills in learners.
Students can read about real-life
scenarios and then analyze the
situation they are presented with.

Ammerman, A., Smith, T. W., & Calancie, L. (2014). Practice-
based evidence in public health: Improving reach,
relevance, and results. Annual Reviews in Public Health , 35 ,
47–63. doi:10.1146/annurev-publhealth-032013-182458

Bahreini, M., Moattari, M., Shahamat, S., Dobaradaran, S., &
Ravanipour, M. (2013). Improvement of Iranian
nurses’ competence through professional portfolio: A
quasi-experimental study, Nursing and Health Sciences ,
15 , 51–57. doi:10.1111/j.1442-2018.2012.00733.x

Balas, M. C., Burke, W. J., Gannon, D., Cohen, M. Z., Colburn, L.,
Bevil, C., . . . Vasilevskis, E. E. (2013). Implementing
the ABCDE bundle into everyday care: Opportuni-
ties, challenges, and lessons learned for implementing
the ICU pain, agitation, and delirium (PAD) guidelines.
Critical Care Medicine , 41 (9 Suppl. 1), S116–S127. doi:
10.1097/CCM.0b013e3182a17064

Bates, O. L., O’Connor, N., Dunn, D., & Hasenau, S. M.
(2014). Applying STAAR interventions in incremental
bundles: Improving post-CABG surgical patient
care. Worldviews on Evidence-Based Nursing , 11 (2),
89–97.

References
Abruzzese, R. S. (1992). Evaluation in nursing staff

development. In R. S. Abruzzese (Ed.), Nursing staff
development: Strategies for success (pp. 235–248). St.
Louis, MO: Mosby–Year Book.

Adams, R. J. (2010). Improving health outcomes with better
patient understanding and education. Dovepress , 2010 (3),
61–72. Retrieved from http://www.ncbi.nlm.nih.gov
/pubmed/22312219

Allen, J., Annells, M., Clark, E., Lang, L., Nunn, R., Petrie, E., &
Robins, A. (2012). Mixed methods evaluation research for
a mental health screening and referral clinical pathway.
Worldviews on Evidence-Based Nursing, 9 (3), 172–185.

American Nurses Credentialing Center, Commission on
Accreditation. (2014, September). The importance of
evaluating the impact of continuing nursing education
on outcomes: Professional nursing practice and patient
care. Retrieved from http://www.nursecredentialing
.org/Accreditation/ResourcesServices/Evaluating-the
-Impact-CNE-Outcomes.pdf

CASE STUDY
Having recently completed her master’s degree in nursing, Sharon has accepted a new role as clinical
nurse educator for three adult medicine units in the medical center where she has been employed as
a staff nurse for the past 6 years. Eager to put her education to practice in a manner that would benefit
both patients and staff, Sharon meets with the nurse managers of the three units to learn what they
view as priority issues on which she should focus. All three managers agree that their primary concern
is teaching their staff how to better prepare patients with type 2 diabetes to care for themselves after
they are discharged home. One manager comments, “Half of my nurses are new graduates. I’m not
even certain that they know much about type 2 diabetes—how on earth can they teach the patients?”
The other two managers nod, agreeing with the first, and chime in: “The patients aren’t being taught
what they need to know, they don’t believe what they’re hearing, or they don’t understand what
they’re hearing. As a result, I’m being told by ambulatory service nurses that our discharged patients
aren’t taking their medications, aren’t making any changes in diet or lifestyle, and seem unconcerned
about their hyperglycemia.”

You next meet with Eric, the certifi ed diabetes educator at your hospital, and he reminds you that
all nurses are mandated to annually review the patient and family education program for patients with
type 2 diabetes and complete the cognitive posttest.

1. Which type of evaluation is being conducted every year when the nurses review the program
and complete the cognitive test?

2. Which type(s) of evaluation would be most relevant to the nurse manager’s concerns?
3. Putting yourself into Sharon’s place, describe in detail an evaluation that you would conduct

with the patients as a primary audience.
4. If evaluation is so crucial to healthcare education, what are some of the reasons why evaluation

seems often an afterthought or is even overlooked entirely by the educator?

628 Chapter 14 Evaluation in Healthcare Education

Susan B. Bastable, EdD, RN
Nursing Education Consultant

Professor Emerita and Founding Chair
Department of Nursing

Purcell School of Professional Studies
Le Moyne College

Syracuse, New York

Nurse as
Educator

Principles of Teaching and
Learning for Nursing Practice

FIFTH EDITION

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Library of Congress Cataloging-in-Publication Data
Names: Bastable, Susan Bacorn, editor.
Title: Nurse as educator : principles of teaching and learning for nursing
practice / edited by Susan B. Bastable.
Description: Fifth edition. | Burlington, Massachusetts : Jones & Bartlett
Learning, [2019] | Includes bibliographical references and index.
Identifiers: LCCN 2017030094 | ISBN 9781284127201 (pbk.)
Subjects: | MESH: Patient Education as Topic–methods | Teaching | Learning |
Nurses’ Instruction
Classification: LCC RT42 | NLM WY 105 | DDC 610.73–dc23
LC record available at https://lccn.loc.gov/2017030094

6048

Printed in the United States of America
21 20 19 18 17 10 9 8 7 6 5 4 3 2 1

In memory of my dear colleague and friend of 43
years, Dr. M. Louise Fitzpatrick, Dean of the College of
Nursing at Villanova University for 4 decades. She was

my advisor during my master’s program and chair
of my doctoral dissertation committee at Columbia

University and a mentor throughout my professional
career. Louise wrote the foreword for my first, second,

and third editions of this text. She was the ultimate
educator and her advice, guidance, support, and

friendship will be dearly missed.

To nursing students and professional colleagues who
over the years have shared their teaching experiences
as well as their knowledge, skills, ideas, and reflections

on the principles of teaching and learning.

viii

© Helaine Weide/Moment/Getty

Chapter 2 Ethical, Legal, and Economic
Foundations of the Educational
Process . . . . . . . . . . . . . . . . . . . . 35

M. Janice Nelson and Kattiria M. Gonzalez

A Differentiated View of Ethics, Morality,
and the Law . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Evolution of Ethical and Legal Principles
in Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Application of Ethical Principles to Patient
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

The Ethics of Education in Classroom
and Practice Settings . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Legality of Patient Education and
Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Legal and Financial Implications
of Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Economic Factors in Healthcare Education:
Justice and Duty Revisited . . . . . . . . . . . . . . . . . . . . 57

Financial Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Program Planning and Implementation . . . . . . . . . . 60

Cost-Benefit Analysis and Cost-Effectiveness
Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

Chapter 3 Applying Learning Theories to
Healthcare Practice . . . . . . . . . 69

Margaret M. Braungart, Richard G. Braungart, and
Pamela R. Gramet

Psychological Learning Theories . . . . . . . . . . . . . . . . . 72

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xii

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv

Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi

About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii

PART 1 Perspectives on Teaching
and Learning 1

Chapter 1 Overview of Education
in Health Care . . . . . . . . . . . . . . . 3

Susan B. Bastable and Kattiria M. Gonzalez

Historical Foundations for Patient Education in
Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

The Evolution of the Teaching Role
of Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Social, Economic, and Political Trends Affecting
Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Purposes, Goals, and Benefits of Patient
and Nursing Staff/Student Education . . . . . . . . . . 12

The Education Process Defined . . . . . . . . . . . . . . . . . . 13

The Contemporary Role of the Nurse as
Educator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Barriers to Teaching and Obstacles
to Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Questions to Be Asked About Teaching
and Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Contents

Contents ix

Neuropsychology and Learning . . . . . . . . . . . . . . . . . 93

Comparison of Learning Theories . . . . . . . . . . . . . . . . 95

Motor Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

Common Principles of Learning . . . . . . . . . . . . . . . . 106

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . 108

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

PART 2 Characteristics of the
Learner 117

Chapter 4 Determinants of Learning . . . 119

Sharon Kitchie

The Educator’s Role in Learning . . . . . . . . . . . . . . . . 121

Assessment of the Learner . . . . . . . . . . . . . . . . . . . . . 121

Assessing Learning Needs . . . . . . . . . . . . . . . . . . . . . 122

Methods to Assess Learning Needs . . . . . . . . . . . . 127

Readiness to Learn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Learning Styles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

Learning Style Models and Instruments . . . . . . . . 140

Interpretation of the Use of Learning
Style Models and Instruments . . . . . . . . . . . . . . . 159

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . 161

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

Chapter 5 Developmental Stages
of the Learner . . . . . . . . . . . . . 169

Susan B. Bastable and Gina M. Myers

Developmental Characteristics . . . . . . . . . . . . . . . . . 171

The Developmental Stages of Childhood . . . . . . 172

The Developmental Stages of Adulthood . . . . . . 192

The Role of the Family in Patient
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . 212

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215

Chapter 6 Compliance, Motivation,
and Health Behaviors of
the Learner . . . . . . . . . . . . . . . 219

Mary Ann Wafer

Compliance and Adherence . . . . . . . . . . . . . . . . . . . 221

Motivation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225

Selected Models and Theories . . . . . . . . . . . . . . . . . 235

Models for Health Education . . . . . . . . . . . . . . . . . . . 244

The Role of Nurse as Educator in Health
Promotion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247

State of the Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . 248

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250

Chapter 7 Literacy in the Adult Client
Population . . . . . . . . . . . . . . . . 257

Susan B. Bastable, Gina M. Myers, and Leigh Bastable
Poitevent

Definition of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

Scope and Incidence of the Problem . . . . . . . . . . . 266

Trends Associated with Literacy Problems . . . . . . 269

Those at Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270

Myths, Stereotypes, and Assumptions . . . . . . . . . . 272

Assessment: Clues to Look For . . . . . . . . . . . . . . . . . 274

Impact of Illiteracy on Motivation
and Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

Ethical, Financial, and Legal Concerns . . . . . . . . . . 277

Readability of Printed Education Materials . . . . . 279

Measurement Tools to Test Literacy Levels . . . . . 281

Formulas to Measure Readability of Printed
Education Materials . . . . . . . . . . . . . . . . . . . . . . . . . 282

Tests to Measure Comprehension of Printed
Education Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . 284

Tests to Measure General Reading Skills
and Health Literacy Skills of Clients . . . . . . . . . . 286

Simplifying the Readability of Printed
Education Materials . . . . . . . . . . . . . . . . . . . . . . . . . 289

Teaching Strategies to Promote Health
Literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297

x Contents

Assistive Technologies . . . . . . . . . . . . . . . . . . . . . . . . . 409

State of the Evidence . . . . . . . . . . . . . . . …

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