Learning Needs of Patient In Nursing Education
What are Learning Needs
Learning needs are defined as gaps in knowledge that exist between a desired level of performance and the actual level of performance (Health Care Education Associates, 1989). In other words, a learning need is the gap between what someone knows and what someone needs or wants to know. Such gaps may arise because of a lack of knowledge, attitude, or skill.
Learning Needs and Role Health Professionals
Of the three determinants of learning. Nurse educators must identify learning needs first so that they can design an instructional plan to address any deficits in the cognitive, effective, or psychomotor domains. Once the educator discovers what needs to be taught, he can determine when and how learning can optimally occur.Of course, not every individual perceives a need for education. Often, learners are unaware of what they do not know or want to know.
Consequently, it is up to the educator to assist learners in identifying, clarifying, and prioritizing their needs and interests. Once these aspects of the learner are determined, the information gathered can, in turn, be used to set objectives and plan appropriate and effective teaching and learning approaches for education to begin at a point suitable to the learner rather than stemming from an unknown or inappropriate place.
Comparison of Need Identification by Patient and Health Professionals
Differences often exist between the perception of needs identified by patients versus the needs identified by the health professionals caring for them. In one study of a convenience sample of 365 cardiac patients who had recent major coronary interventions performed. their preferences for learning after the intervention were different from what 166 cardiac nurses perceived as important for the patient to learn (Mosleh, Eshah , & Almalik, 2017).
Other authors have also substantiated comparative in congruence in the perception of learning needs by patients and providers ( Ançel , 2012 Kilonzo & O'Connell, 2011; Roy, Gasquoine , Caldwell, & Nash, 2015; Wu, Tung. Liang, Lee, & Yu , 2014; Yonaty & Kitchie , 2012).According to well known experts in behavioral and social sciences (Bloom, 1968; Bruner, 1966; Carroll, 1963; Kessels , 2003; Ley, 1979; Skinner, 1954), most learners 90-95% of them can master a subject with a high degree of success if given sufficient time and appropriate support.
It is the educator's task to facilitate the determination of what exactly needs to be learned and to identify approaches for presenting information in a way that the learner will best understand. Recent evidence of success at mastery learning is illustrated by Roberts, Ingram, Flack, and Jones Hayes (2013) when they implemented this type of learning in a nursing education program. The authors witness then increase in the National Council Licensure Examination (NCLEX) scores among a diverse student population.
Process and Steps to Identify Learning Needs
The following are important steps in the assessment of learning needs:
1. Identify the Learner
2. Choose the right setting
Establishing a trusting environment helps learners feel a sense of security in confiding information, believe their concerns are taken seriously and are considered important, and feel respected. Ensuring privacy and confidentiality is recognized as essential to establishing a trusting relationship.
3. Collect data about the learner
Once the learner is identified, the educator can determine characteristic needs of the population by exploring typical health problems or issues of interest to that population. Subsequently, a literature search can assist the educator in identifying the type and extent of content to be included in teaching sessions as well as the educational strategies for teaching a specific population based on the analysis of needs. For example, systematic reviews offer an excellent way to become aware of the published research about learning needs of specific populations.
One recent article (Nightingale, Friedl, & Swallow, 2015) reviewed 23 studies that identified parents' learning needs about managing their child's chronic long term health condition. Moore et al. (2013) reviewed studies about the palliative and supportive care needs of patients diagnosed with high grade glioma and their caregivers. These systematic reviews identified key topics related to patient education, such as the need for consistent well-delivered information around disease sequelae, treatment, and resources available for patients and their significant others.
4.Collect data from the learner
Learners are usually the most important source of needs assessment data about themselves. Allow patients and/or family members to identify what is important to them, what they perceive their needs to be, which types of social support systems are available, and which type of assistance these supports can provide. If the audience for teaching consists of staff members or students, solicit information from them as to those areas of practice in which they feel they need new or additional information (Cannon, Watson, Roth, & LaVergne, 2014; Winslow et al., 2016 ).
Actively engaging learners in defining their own problems and needs motivates them to learn because they are invested in planning for a program specifically tailored to their unique circumstances. Also, the learner is important to include as a source of information because, as noted previously, the educator may not always perceive the same learning needs as the learner.
5. Involve members of the healthcare team
Other health professionals likely have insight into patient or family needs or the educational needs of the nursing staff or students resulting from their frequent contacts with both consumers and caregivers. Nurses are not the sole educators of these individuals; thus, they must remember to collaborate with other members of the healthcare team for a richer assessment of learning needs. This consideration is especially important because time for assessment is often limited.
In addition to other health professionals, organizations such as the American Heart Association, the American Diabetes Association, and the American Cancer Society are excellent sources of health information. Prioritize needs. A list of identified needs can become endless and seemingly impossible to accomplish. Maslow's (1970) hierarchy of human needs can help the educator prioritize so that the learner's basic needs are attended to first and foremost before higher needs are addressed.
For example, learning about a low-sodium diet likely cannot occur if a patient faces problems with basic physiological needs such as pain and discomfort; the latter needs should be addressed before any other higher order learning is expected to occur. Setting priorities for learning is often difficult when the nurse educator is faced with many learning needs in several areas. Prioritizing the identified needs helps the patient or staff member to set realistic and achievable learning goals.
Choosing which information to cover is imperative, and nurse educators must make choices deliberately. Educators should prioritize learning needs based on the criteria in BOX4-1 (HealthCare Education Associates, 1989, p. 23) to foster maximum learning.
Without good assessment, a common mistake is to provide more information than the patient wants or needs. To avoid this problem, the nurse must discriminate between information that patients need to know versus information that is nice for them to know. Often, highly technical information merely serves to confuse and distract patients from the essential information they need to carry out their regimen (Hansen & Fisher, 1998; Kessels , 2003).
6. Education in and of itself is not always the answer to a problem
Often, healthcare providers believe that more education is necessary when something goes wrong, when something is not being done, when a patient is not following a prescribed regimen, or when a staff member does not adhere to a protocol. In such instances, always look for other non-learning needs. For example, the nurse may discover that the patient is not taking his medication and may begin a teaching plan without adequate assessment.
The patient may already understand the importance of taking a prescribed medication, know how to administer it, and be willing to follow the regimen, but his financial resources may not be sufficient to purchase the medication. In this case, the patient does not have a learning need but rather requires social or financial support to obtain the medication.
7. Determine availability of educational resources
The educator may identify a need, but it may be useless to proceed with interventions if the proper educational resources are not available, are unrealistic to obtain, or do not match the learner's needs. In this case, it may be better to focus on other identified needs. For example, a patient who has asthma needs to learn how to use an inhaler and peak-flow meter. The nurse educator may determine that this patient learns best if the nurse first gives a demonstration of the use of the inhaler and peak flow meter and then allows the patient the opportunity to perform a return demonstration.
If the proper equipment is not available for demonstration/return demonstration at that moment, it might be better for the nurse educator to concentrate on teaching the signs and symptoms the patient might experience when having poor air exchange than it is to cancel the encounter altogether. Thereafter, the educator would work immediately on obtaining the necessary equipment for future encounters,
8. Assess the demands of the organization
This assessment yields information that reflects the climate of the organization. What are the organization's philosophy, mission, strategic plan, and goals? The educator should be familiar with standards of performance required in various employee categories, along with job descriptions and hospital, professional, and agency regulations. If, for example, the organization is focused on health promotion versus trauma care, then there likely will be a different educational focus or emphasis that dictates learning needs of both consumers and employees.
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