Developmental Stages and Nursing Education of Patient
Age Related Changes and Health Care Requirement
In an extensive review of the literature, a significant number of studies, from both primary and secondary sources, that were carried out by nurses and other healthcare professionals were found to support the application of teaching and learning principles to the education of middle aged and older adult clients in various healthcare settings.
However, current nursing and healthcare research focusing specifically on patient education approaches applicable to the age cohorts of children, adolescents, and the young adult population, as well as instructional needs of family members as caregivers, is lacking.
For example, the article by Richmond and Kotelchuck (1984), written more than 3 decades ago, remains an excellent and thorough examination of health maintenance in children, including children's cognitive understanding of health and disease, their psychological control over health, parental and media influences on health behaviors, the impact of school health education, and the role of health professionals in the management of childhood illness and health services for children.
Standards and Guidelines for Children Developmental Stages
Currently, the National Resource Center for Health and Safety in Child Care and Early Education (2017) publishes up-to-date information on performance standards and guidelines for a program of health care activities for children. However, updated information in the healthcare literature on the application of new approaches to foster child health is sorely needed.
To reinforce general understanding of the physical, cognitive, and psycho social (emotional) traits of human development across the life span, plenty of excellent resources, well grounded by research evidence, exist in the fields of psychology in general and educational psychology, in particular. However, much of the educational psychology literature focuses extensively on the application of teaching and learning principles only to preschool and K-12 classrooms.
Developmental Stages and Health Education and View of Scientists
Understandably life span developmental scientists do not specifically consider health education of well individuals with respect to disease prevention, risk reduction, and health promotion efforts or to health promotion, maintenance, and rehabilitation measures for persons who are acutely and chronically ill. The application and translation of developmental characteristics to the teaching and learning aspects of healthcare delivery are the responsibility of nurses and other healthcare providers.
Much more research is needed to demonstrate how to effectively teach clients at different developmental stages based on their learning needs, learning styles, and readiness to learn, thereby ensuring achievement of the most positive client centered outcomes possible.Malcolm Knowles's original 1973 theory about adult learning and his subsequent modifications and clarifications of his theory (Knowles, 1990; Knowles et al., 2015) seem to be well accepted and have stood the test of time.
Piaget's theory on cognitive development has also been accepted and extensively applied over the years, but recent critics of Piaget have challenged the assumptions underlying his theory with respect to the last stage of development (formal operations). Today, psychologists speculate that a fifth and qualitatively higher level of thinking follows adolescence, a stage postulated as the post formal operations period of adulthood.
Vygotsky's social cultural theory adds another dimension to understanding cognitive development that was not addressed by Piaget (Crandell et al., 2012; Santrock, 2017). A contemporary interpretation of Vygotsky's theory to the classroom is the current interest in collaborative group learning with peers (McLeod, 2007).Erikson's theory of the eight stages of psycho-social development, whereby individuals face unique stage related tasks (crises that must be resolved to reduce one's vulnerability and enhance one's potential), is still recognized as elucidating the unique turning points in life that require successful completion for healthy, normal development to occur.
Although Erikson's theory continues to be widely applied to the field of life-span development, the existence of a ninth stage of development, hope and faith versus despair, has received relatively little attention in the literature. More research is needed to confirm the existence of this final stage of psycho-social development, which addresses the unique tasks of the oldest-old (Erikson & Erikson, 1998).
Developmental Stages and Teaching Methods
Recently, increased attention has been paid to the appropriateness of teaching methods and instructional materials (especially as they relate to multimedia technology) for college-aged students and adult learners to meet their expectations for lifelong learning. Given the fact that the population is steadily aging, nurses are caring for an increasingly older audience of learners. Many of today's nursing students are somewhat older than the traditional college aged students, and nursing staff are adult continuing-education learners.
It is gratifying to witness the acknowledgment of these population changes through an emphasis on studying generational differences in learner preferences, modes of information processing, and memory and recall with respect to the impact of standard versus newer technological methods and tools for the effective delivery of instruction . The literature, such as the articles written by Billings and Kowalski (2004), Fishman (2016), and Shatto and Erwin ( 2016), highlight the different experiences, values, beliefs, and needs of learners from varied generational backgrounds.
Although there has been an upsurge of interest in educational strategies and techniques for teaching and learning as they apply to certain population groups in the broad health care arena, much more research needs to be done regarding the creative leadership role of the nurse educator functioning as facilitator rather than teacher of patients and family members (at all stages of development) and of nursing students and staff (Donner, Levonian, & Slutsky, 2005).
Research on Developmental Learning and Level of Illness
Research has only begun to scratch the surface of how teaching and learning are affected by situational variables, such as chronic illness, acute illness, disability, or wellness; by personality traits, such as motivation and learning styles; by temperament responses, such as anxiety and attention span; and by socio-cultural influences, such as gender, economic status, and educational background.
Another area requiring further exploration is the role of family and other support systems on the success of educational endeavors to help Americans of all ages maintain and improve their health status. Much more evidence from research needs to be conducted on family structure and the many changing relationships in society that promote or hinder teaching and learning of clients in various healthcare settings.
The national initiatives of Healthy People 2020, as well as pending policy goals at local and state levels, will not be realized unless a better understanding is gained of the impact of physical, cognitive, psychological/emotional, and socio-cultural changes that occur across the life course that can serve as a guideline for teaching and learning in nursing and health care practice.
Role of Nurses Educator and Developmental Learning
For nurses, it is important to understand the specific and varied tasks associated with each developmental stage to individualize the approach to education in meeting the needs and desires of clients and their families. Assessment of physical, cognitive, and psycho-social maturation within each developmental period is crucial in determining the appropriate strategies to facilitate the teaching-learning process.
The younger learner is, in many ways, very different from the adult learner. Issues of dependency, extent of participation, rate of and capacity for learning, and situational and emotional obstacles to learning vary significantly across the various phases of development.Readiness to learn in children is very subject centered and highly influenced by their physical, cognitive, and psycho-social maturation.
By comparison, motivation to learn in adults is very problem centered and more oriented to psycho-social tasks related to roles and expectations of work, family, and community activities.For client education to be effective, the nurse in the role of educator must create an environment conducive to learning by presenting information at the learner's level, inviting participation and feedback, and identifying whether parental, family, and/or peer involvement is appropriate or necessary.
Nurses are the main source of health information. In concert with the client, they must facilitate the teaching-learning process by determining what needs to be taught, when to teach, how to teach, and who should be the focus of teaching based on the developmental stage of the learner.
When nursing students and staff are the audience of learners, the educator is also responsible for assuming the leadership role as earner facilitator of the learning process. In conjunction with these adult learners, nurse educators can establish objectives and learner-centered approaches that challenge the educator's creativity to foster self-direction, motivation, interest, and active participation for independence and interdependence in learning.
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