Patient Education and Educative Nursing Practice Readings: pg 283-303 (CH15) + 2 articles History of Educative Nursing Practice - Before and into the 1960’s, nurses’ work was largely task-oriented, directed at routine client care, and also chores such as cleaning floors, carrying trays, and cleaning equipment. - In response to the increasingly complex hospital workplace, the concept of progressive client care was adopted, which is the progression from intensive care unit (ICU) to intermediate care, self-care, long-term care, and home care - In the 1970’s, Dr. Moyra Allen at McGill university led the development of the McGill Model of Nursing, a vision of nursing in which health promotion is the primary goal of nursing. According to the McGill model, because health is a learned process, the goal of nursing is to engage the client and family in the process of learning about and acquiring healthier ways of living. - Current models of nursing and health-promoting nursing practice emphasizes that in the educative role, the nurse and the client/family share expertise. Theories and Educative Nursing Practice - There are 5 main schools of thought that have influenced educational nursing practice to date: behaviourism, cognitivism, humanism, constructivism, and andragogy. - All have in common that learning brings about change; however, how this change happens is open to debate among theorists - Behaviourism - Burrhus Frederick Skinner - Learning occurs when teachers reinforce or reward the consequences of learning. Accordingly, it is solely the teacher’s responsibility to provide the reinforcements that will determine the learners motivation to learn - Behaviourism assumes that the teacher is in control and that the student remains passive - Measurable and observable indicators of behavioural change - Cognitivism - Cognitivists view the human brain as though it is a computer in which data (information) are stored, processed, and then produces specific learning responses. Learners, according to this view, are logical, rational beings who learn best when actively involved in developing mental structures for processing information - Functions of the brain that are involved in the processing of information: thinking, memorizing, comprehending, and problem-solving - Learning involves expectations, drawing inferences, and making connections - Critics of cognitivism point out that learning is more than just rational thinking and often involves language and emotion - Humanism - - - Carl Rogers Belief that dignity and autonomy of people are sacred (deeping emotions, attitudes, and insights - Central to humanistic education theories is the belief that the educative relationship must be enacted in ways that promote individual freedom and respect for the learner’s individuality and honor the right of learners to determine the nature of their learning - Teaching is focused on what the clients say they need and want - Critics suggest that not all people over the age of 18 are capable or desirous of determining their learning goals or how best to learn Constructivism - A central belief in the theory of constructivism is that people develop knowledge and meaning by building and reflecting on their experiences. Reflecting on experiences enables learners to generate their personal principles and mental models to make sense of their experiences - Learners actively apply what they have learned and understood from past and current experiences to real-world situations - Some critics say that the theory does not take into consideration that the teacher may have expert knowledge that could be beneficial to the learner - Social constructivism is a genre within constructivist theories, attributed to Lev Vygotsky - proposing that new knowledge is formulated in social interactions and that the use of language plays a key role in acquiring new understandings Andragogy - Malcolm Knowles - Knowles believed that adults learn in distinctly different ways from children - Highlights the need for educators of adults to focus on the process of learning, not the content they teach - The teacher takes into account that every adult is different. They consider the client’s unique background, preferred way of learning, and past experiences in planning the learning activity. They also encourage adults to discover some things through experience, but they are there to offer guidance and encouragement as necessary Understanding the Common Features of Learning - Imposter syndrome: the belief that everyone else is smarter than you and it's only a matter of time before the educator finds out - Students with this syndrome will be very quiet, and afraid to talk, others will talk all the time to cover their believed imposter status. - Emotionality - Incremental fluctuation Learning Climate - The learning climate is the context or the atmosphere in which learning takes place Educative Nursing Practice Framework - I got bored