Functional Utility Model In Nursing Education and Conceptualization
Educator Agreement with Model Conceptualizations
Nurses as educators have their own belief systems, which may or may not agree with some of the tenets of each of the models presented. The choice of a model, therefore, can be based on the educator’s level of agreement with salient factors in each framework.
Likelihood of action is best addressed by the health belief model, whereas attaining positive health outcomes is the focus of the protection motivation theory. Attitude and intention are best viewed through the theory of reasoned action and the theory of planned behavior.
Belief in one’s capabilities is best addressed by self-efficacy theory, and the therapeutic alliance model is best used for reduction of noncompliance through an educator learner collaboration. Staging the individual’s readiness for change and developing strategies for interventions are helpful in de- signing educational programs with the stages of change model.
Through in-depth analysis of each model, the attention of the educator may be drawn to other factors as well. Ultimately, the model or models that fit best with the educator’s own beliefs are more likely to be chosen.
Functional Utility of Models In Nursing Education
Model selection for educational purposes also can be based on functional utility. The following questions may be asked to determine functional utility:
Who is the target learner?
What is the focus of the learning? When is the optimal time?
Where is the process to be carried out?
The question of who the learner is deals with whether the target learner is the individual, family, or group. The health belief model, health promotion model, self efficacy theory, protection motivation theory, stages of change model, theory of reasoned action, and theory of planned behavior can be used across the range of these target learners.
The important notion for the nurse as educator to remember is the probability of individual variation. Another consideration in terms of the target learner is the various categorical groups that can be distinguished, such as those considered at high risk and those diagnosed with acute or chronic illnesses.
The functional utility of the models also can be determined by the content needed, the timing of the educational experience, and the setting in which the learning is to take place. What is needed reflects the focus of the learning and addresses the content to be taught, such as disease processes, specific disease treatment, adaptation techniques, promotion of wellness, expectations of specific health practices, or focus on self care.
The question of when deals with optimal timing and refers to the readiness of the learner, a mutually convenient time, and prevention of untimely delays in moving toward a desired goal. Although considered important in the context of health education, this critical factor has received little specific reference in terms of health promotion models.
Except for the stages of change model, timing often is a neglected factor in the models discussed in this chapter. It is apparent that determining optimal time can be a motivational incentive in terms of meeting the health needs of the learner.
Addressing the question of where the educational process is to be carried out is another aspect of functional utility. The home, workplace, school, institution, and specific community locations are all options as settings. Every model discussed in this chapter lends itself to these diverse settings.
Integration of Models for Use in Education
Theories provide blueprints for interventions (Molisani, 2015). From the previous discussion, clearly the integration of various components of health behavior models is advantageous in the educational process. When salient factors are taken into consideration in relation to the specific developmental stage of the learner, an integrated motivational model of learning in health promotion could emerge, Recent literature proposes model integration.
For example, Gebhardt and Maes (2001) advocate a multi theory approach to promote health behaviors. Cautioning against the use of unidirectional and non-dynamic views of behavioral change, they propose an integrative approach using goal theories and stages of change.
Poss (2001) developed a new model synthesizing the health belief model and the theory of reasoned action, noting that a synthesized model is appropriate for the study of persons from varying cultural backgrounds. Chiu (2005) investigated the previously un tested Bruhn and Parcel (1982) model of children’s health promotion in adolescents with type 1 diabetes using structural equation modeling analysis.
Finding only partial support for this model, she suggested a new model that would incorporate self-efficacy as well as locus of control. The development of new models or revision of older models is a necessary step in the evolution and delivery of health care, and it necessarily affects the educator who is concerned with motivational behaviors of the learner.
Salient health promotion factors that nurse educators can use in a multi theory approach to health education include, but are not limited to, level of knowledge, attitudes, values, beliefs, perceptions, level of anxiety, self confidence, skills mastery, past experiences, intention, physiological capacity, socio-cultural enablers, environment, educator learner alliance, resources and reinforcements, mutual and realistic goal setting, hierarchy of needs, quality of life, and voluntary participation in learning.
Developmental stages of the learner in corporate principles of pedagogy (teaching children), andragogy (teaching adults), and geragogy (teaching older adults) to meet the needs of the learner. A more comprehensive and holistic model for the nurse as educator could emerge when learning is viewed along a unidirectional developmental continuum, in combination with salient health promotion factors.
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