Types of Written Instructional Materials In Nursing Education

Types of Instructional Materials In Nursing Education

Written Materials In Nursing Education,Disadvantages of Written Materials In Nursing Education,Commercially Prepared Materials In Nursing Education,Self Composed Materials In Nursing Education,Evaluation of  Printed Materials In Nursing Education.

Written Materials In Nursing Education

    Handouts, such as leaflets, books, pamphlets, brochures, and instruction sheets (all symbolic representations), are the most widely used and most accessible type of tools for teaching. Printed materials have been described as “frozen language” (Redman, 2007, p. 34) and are the most common form of teaching aid because of the distinct advantages they provide to enhance teaching and learning. 

The greatest strengths of written materials are as follows:

• Available as a reference to reinforce information for learners when the nurse is not immediately present to answer questions or clarify information.
• Widely used at all levels of society, so this medium is acceptable and familiar to the public.
• Easily obtained through commercial sources, usually at relatively low cost and on a wide variety of subjects, for distribution by educators.
• Provided in convenient forms, such as pamphlets, which are portable, reusable, and do not require software or hardware resources for access. Becoming more widely available in languages other than English due to the recognition of significant cultural and ethnic shifts in the general population.
• Suitable for large numbers of learners who prefer reading as opposed to receiving messages in other formats.

Disadvantages of Written Materials In Nursing Education

    Flexible in that the information is absorbed at a speed controlled by the reader. The disadvantages of printed materials include the following facts: 

• Written words are the most abstract form through which to convey information. Immediate feedback on the information presented may be limited.
• A large percentage of materials are written at too high levels for reading and comprehension by many patients (Doak, Doak, Friedell, & Meade, 1998; Mayer & Villaire, 2009). Written materials are inappropriate for persons with visual or cognitive impairment.

Commercially Prepared Materials In Nursing Education

    A variety of brochures, posters, pamphlets, and client-focused instructional sheets are available from commercial vendors. Whether such materials enhance the quality of learning is an important question for nurse educators to consider when evaluating these products for content, readability, and presentation. Commercial products may or may not be produced in collaboration with health professionals, which raises the question of how factual and understandable the information may be. 

    For example, materials prepared by pharmaceutical companies or medical supply companies might not be free of bias and may contain complex language. Educators must ask several questions when reviewing printed materials that have been prepared commercially, including the following:

    Who produced the item? Evidence should make it clear whether input was provided by a nurse or other healthcare professional with expertise in the subject matter. Can the item be previewed? The educator should have an opportunity to examine the accuracy and appropriateness of content to ensure that the information needed by the target audience is provided.

• Is the price of the instructional tool consistent with its educational value? Can the tool be used with large numbers of learners? Simple printed instruction sheets may do the job just as well at less expense and can provide the educator with the ability to update the information on a more frequent basis.
• How quickly will the information become outdated?

    The main advantage of using commercial materials is that they are readily available and can be obtained in bulk for free or at a relatively low cost (Fraze. Griffith, Green, & McElroy. 2010). A nurse educator might need to spend hours researching, writing, and copying materials to create informational resources of equal quality and value, so commercially produced materials can save valuable time. 

    Also, some commercial materials are available online that can be customized to the needs of individual clients.The disadvantages of using commercial materials include issues of cost, accuracy and adequacy of content, and readability of the materials. Some educational booklets are expensive to purchase and impractical to give away in large quantities. 

    Fraze et al. (2010) have developed a checklist to help healthcare providers determine the appropriateness of printed education materials for use by their clients for improvement of health outcomes in various clinical settings. 

Self Composed Materials In Nursing Education

    Nurse educators may choose to write their own instructional materials to save costs or to tailor content to specific audiences. Composing materials offers many advantages (Brownson, 1998; Doak et al., 1998). For example, by writing their own materials, educators can tailor the information to accomplish the following points: Fit the institution's policies, procedures, and equipment

• Build in answers to those questions asked most frequently by clients Highlight points considered especially important by the team of physicians, nurses, and other health professionals at their institution or agency
• Reinforce specific oral instructions that clarify difficult concepts and address specific patient needsDoak et al. (1998) outline specific suggestions for tailoring information to help clients want to read and remember the message and to act on it. 

    These authors define tailored instruction as personalizing the message so that the content, structure, and image fit an individual's learning needs. To accomplish this goal, they suggest techniques such as writing the client's name on the cover of a pamphlet and opening a pamphlet with a client and highlighting the most important information as it is verbally reviewed. 

    In another example, Feldman (2004) describes successful use of childcare checklists that had simple line drawings (no more than two to a page) along with brief written descriptions that led parents with cognitive disabilities through specific care tasks, such as bathing a baby, in a step-by-step fashion. Audiotapes also accompany these pictures and simple instructions. 

    Additional studies support the effectiveness of tailored instruction over non tailored messages in achieving reading, recall, and follow through in health teaching (Campbell et al., 1994; Skinner, Strecher, & Hospers, 1994),Of course, composing materials also has dis- advantages. Educators need to be extra careful to be sure that materials are well written, attractive, and well laid out, which can be a time-consuming task. 

    Although nurse educators are expected to enhance their methods of teaching with instructional materials, few have ever had formal training in the development and application of written materials. Many tools produced by nurses are too long, too detailed, and written at too high a level for the target audience (Doak, Doak, & Root, 1996; Brownson, 1998). 

    Also, Doak et al. (1996), Brownson (1998), and Aldridge (2004) suggest the following important tips to be sure self-composed printed education materials (PEMs) are clear and appropriate:Make certain the content is accurate and up to date.

    Organize the content in a logical, step-by-step, simple fashion so that learners are being informed adequately but are not overwhelmed with large amounts of information. Avoid giving details because they may unnecessarily lengthen the written information and make it more complex than it should be. Prioritize the content to address only what learners need to know. Content that is nice to know can be addressed verbally on an individual basis.

    Make sure the information clearly and concisely discusses the what, how, and when. Follow the KISS rule: Keep it simple and smart. This can best be accomplished by putting the information into a question-and-answer format or by dividing the content into subheadings according to key topics to be addressed.

    Avoid medical jargon whenever possible, and define any technical terms using simple, everyday language. If it is important to expose patients to technical terms because these are what they will hear when dealing with their medical situation and with the medical team, define the terms carefully and simply and be consistent with the words used. 

    Find out the average grade in school completed by the targeted client population, and write the client education materials two to four grade levels below the average calculated. For individuals who are not lite-rate, pictures can increase recall of spoken medical instruction (Houts et al., 1998; Houts, Doak, Doak, & Loscalzo, 2006; Kessels, 2003).

    Always state things in positive, not negative, terms. Never illustrate incorrect messages. For example, showing a hand holding a metered-dose inhaler in the mouth not only in- correctly illustrates a drug delivery technique (Weixler, 1994) but also reinforces that message through the image's visual impact alone. 

    In addition to the guidelines for clarity in constructing written materials, format and appearance are equally important in motivating learners to read the printed word. If the format and appearance are too detailed, learners will feel overwhelmed; in such a case, instead of attracting the learners, you will discourage and turn them off. 

Evaluation of  Printed Materials In Nursing Education

 When evaluating PEMs, nurses should keep in mind the following considerations.

1.Nature of the audience. What is the average age of the audience? For instance, adults who are literate tend to prefer printed materials that they can read at their leisure. Children or clients who have low literacy skills, however, like short and simple printed materials with many illustrations also do not like to read. 

    Information in the form of simple pictures, graphs, and charts can be included with the content of printed materials for the benefit of those individuals who have low literacy skills or who are visual and conceptual learners (Houts et al., 2006).

    In addition, does the hearing have any sensory deficits? Vision problems are common among older adult clients, and deficits in short-term memory may pose a problem for comprehension. Having materials that can be reread at the learner's own convenience and pace can reinforce earlier learning and reduce confusion over treatment instructions. For those individuals with vision impairments, use a large typeface and lots of white space, separate one section from another with plenty of spacing, highlight important points, and use black print on white paper.

2.Literacy level required. PEMs for helping the learner accomplish behavioral objectives will not be effective if the materials are written at a level beyond the ability of the learner to understand (Mayer & Villaire, 2009; Wolf & Bailey, 2009). The Joint Commission (2007) mandates that health information be presented in a manner that can be understood by patients and family members. 

3. Linguistic variety available. This refers to choices of printed materials in different languages that may be accessed. However, these options often are limited because duplicate materials in more than one language are costly to publish and not likely to always be produced unless the publisher anticipates a large demand. 

    The growth of minority populations in the United States has promoted increasing attention to the need for non English teaching materials. Regional differences exist, such that there may be greater availability of Asian-language materials on the West Coast and more Spanish-language materials in the Southwest and Northeast than in other parts of the United States.

4. Clarity and brevity. Simpler is better. Shorter also is better. Remind yourself of the KISS rule: Keep it simple and smart. Address the important facts only. What does the client need to know? Choose words that explain how; the why can be filled in later during for example, one-to-one instruction or group discussion. 

    Include uncomplicated pictures and basic illustrations that show the written instructions step by step.By using simple, clear graphics and a few words, the learner is guided through the procedure with very little room for misunderstanding, and this tool is suitable for a wide range of audiences.

5. Layout and appearance. How written materials look is crucial in attracting the attention of patients and getting them to read the information. If a tool has too much wording, with few spaces between sentences and paragraphs, small margins, and many pages of content, the learner may find it much too difficult and too time consuming to read. 

    Allowing plenty of white: space is the most important step that educators can take to improve the appearance of written materials. This means creating a lot of blank space between and around the words by double spacing, leaving wide margins, indenting important points, using bold lettering, and separating key statements with extra space. Putting a graphic in the middle of the text can break up the print and provide a way to reinforce the written information. 

    Redman (2007) states that pictures rather than spoken words are better for learning because they increase recognition and recall. An example used earlier in this chapter is teaching the psychomotor task of using a metered-dose inhaler. 

6.Opportunity for repetition. Written materials can be read later and again and again by the learner to reinforce the teaching when the educator is not there to answer questions. Thus, it is an advantage if materials are laid out in a simple question-and-answer format. 

    Questions demand answers, and this format allows clients to find information easily for repeated reinforcement of important messages. If educators write their own materials, they also must be mindful of the need to keep information current and to update it for changing protocols and varied patient populations.

7.Concreteness and familiarity. Using the active voice (present tense) is more immediate, directive, and concrete. For example, “Shake the inhaler very well three times” is more effective than “The inhaler should be shaken thoroughly”. Also, the importance of using plain language instead of medical jargon cannot be stressed enough. 

    Inadequate client understanding of common medical terms used by healthcare providers is a significant factor in noncompliance with medical regimens. Numerous studies indicate that clients understand medical terms at a much lower rate than nurses expect (D'Allessandro, Kingsley, & Johnson  West, 2001; Estey, Musseau, & Keehn, 1994; Friedman et al., 2011; Lerner, Jehle, Janicke, & Moscati, 2000; Mayer & Villaire, 2009).

    In summary, educator-designed or commercially produced PEMs are widely used for a broad range of audiences. They vary in literacy demand levels and may be found written in several languages. Studies of the effectiveness of PEMS on patient health outcomes have reported varied results. If PEMs are used alone, the effect has been small (Giguere et al., 2012). 

    If used in combination with written and verbal information, they improve learners' knowledge and satisfaction with care (Johnson & Sandford, 2005). The literacy level of written communication materials is a major factor in the usefulness of print materials (D'Allessandro et al., 2001; Mayer & Villaire, 2009).