Barrier

Explanation

Teaching Implications

Acute illness

Client requires all resources to cope with illness.

Defer teaching until client is less ill.

Pain

Pain decreases ability to concentrate.

Eliminate or decrease pain before teaching.

Age-Elderly

Vision, hearing and motor control may be impaired in the elderly.

Allow for sensory and motor deficits in teaching.

Age-Young

Developmental age limits ability to learn.

Adjust teaching for developmental age 
and/or teach the caregiver.

Biorhythms

Individuals have unique circadian (daily) rhythms that influence optimal learning.

Determine client's optimal learning time 
and teach at that time.

Emotion

Intense emotions require energy and distract from learning.

Deal with emotions before teaching.

Ethnocultural factors

Client may have a language barrier or other cultural factors that inhibit learning.

Determine if language/cultural factors play 
a role and resolve before teaching.

Environmental factors

Environment may be uncomfortable, noisy, or lack privacy.

Resolve distractions in the environment.

Iatrogenic factors

Other factors may influence learning, such as a hurried, condescending attitude or ignoring client cues.

Use active listening and establish a rapport before teaching.

STRATEGIES

TYPE OF LEARNING

CHARACTERISTICS

Description/explanation (lecture) with questions

Cognitive

Teacher controls content and pace.

Learner is often a passive participant; therefore retention of information is lower.

Feedback (i.e. learners answering questions) is determined by teacher.

Learner may need to overcome perceptions that asking questions is impolite or embarrassing to the teacher.

Teacher may need to confirm that the question has been answered for the learner.

Group discussion

Affective, Cognitive

Learner can obtain assistance from a supportive group.

Group members can learn from each other.

Teacher needs to guide discussion so various individuals participate and stay within focus of the discussion.

One-to-one discussion

Affective, Cognitive

Encourages participation by individual learner; however, learner may feel singled out and have increased anxiety.

Permits individual reinforcement and repetition as needed.

Permits discussion and questions related to sensitive subjects.  

Discovery

Cognitive, Affective

Teacher guides learner through a problem-solving 
     situation.
Learner is an active participant; therefore retention of  
     information is high. 

Role playing

Affective, Cognitive

Permits expression of attitudes, values, and emotions.
Involves active participation of the learner.
Assists with development of communication skills.
Teacher must create a supportive, safe 
      environment for learners to minimize their anxiety. 

Role modeling

Affective, Psychomotor

Teacher sets example by attitudes and psychomotor
      skills.

Demonstration

Psychomotor, Cognitive

Often used with an explanation.

Learner is passive--does not permit use of equipment by learner.

Return demonstration

Psychomotor

Permits a hands-on experience.

Allows repetition and immediate feedback.

Printed and audiovisual

materials

Cognitive

Learners can proceed at their own pace.
Teachers need not be present for learning.
Can be ineffective if reading level is too high, if English skills  are low, or if skill presentation is 
      confusing.

Computer-assisted learning

Cognitive, Psychomotor

Learner is an active participant.

Provides immediate reinforcement and review.

Can be anxiety-producing (if equipment and software 
is complex) or anxiety reducing (learner can work alone or with group at own pace).

Accuracy

·         Are facts, figures, diagrams, videos, and pictures accurate and current?

Content

·         Is content appropriate for the intended client user (age/development)?

·         Does the content highlight major areas of difficulties/problems that clients 
frequently experience?

Educational
Materials

·         Are objectives explicitly stated, reasonable in number, and highlight areas of 
concern?

·         Is the content current and organized in a logical manner?

·         Does the material progress from simple to complex?

·         Does the material include step-by-step explanations of skills or tasks that the client 
is to perform?

·         Are there sufficient materials for the audience?

Communication

·         Is the reading level appropriate for the intended audience?

·         Does the text use commonly used terms, define medical terms, and is the text free 
of medical jargon?

·         Are ideas presented clearly and concisely?

·         Is the technical quality of the material appropriate (such as print size, layout, pictures, 
diagrams, color)?

Cost Effectiveness

·         Does the benefit of the material justify the cost?

·         Could the material be obtained in a less costly way (such as in bulk or through 
non-profit organizations)?

Technology

·         If special equipment is required, is it available?

TYPE OF MEDIA

ADVANTAGES

DISADVANTAGES

Films/Videos

·         Allows animation.

·         Allows time lapse.

·         Simulates sight and sound.

·         Can elicit emotional responses and 
affect attitudes.

·         Appropriate for large/small 
groups.

·         May be expensive to purchase.

·         Equipment is cumbersome.

·         May have technical problems.

·         Has fixed sequencing.

·         Requires at least moderate darkness.

PowerPoint

·         Stable sequence--can be stored on 
disk.

·         Initial cost of program, then 
inexpensive.

·         Easily produced and revised.

·         Able to pause/hold/repeat screen.

·         Can include color graphs and 
pictures.

·         Appropriate for groups/individuals

·         Requires expensive equipment.

·         May have technical problems.

·         Decreased flexibility during program.

·         Requires at least moderate darkness.

Transparencies

·         Inexpensive.

·         Easy to prepare and revise.

·         Lights can be on; increases teacher/audience 
eye contact.

·         Can be used as blackboard.

·         Allows variable sequencing.

·         Equipment is simple to operate.

·         Appropriate for large/small groups

·            Equipment is cumbersome.

·            Poorly prepared transparencies can be distracting.

Models

·         Allows multi-sensory involvement.

·         Allows demonstration and practice 
in safe environment.

·         Equipment is usually expensive.

·         May be fragile and easily damaged.

·         May not be easily available.

·         Cannot be utilized by large group.

Computer Assisted 
Technology

·         Can be individualized to learner.

·         Can offer simulated situations in safe 
environment.

·         Can be made available at the convenience 
of the learner.

·         Can incorporate sight and sound.

·         Can provide immediate feedback and interaction with learner.

·         Expensive to purchase.

·         Requires expensive equipment.

·         Equipment is cumbersome.

·         May have technical problems.

·         Cannot be used by large groups.

·         If poorly produced, can be distracting and uninteresting for the learner.    

Cognitive Level

Health Concept

Self-Care

Teaching Approaches

Sensorimotor

Infancy/Toddler

2-4 years 

No concept of health

Total dependency to simple tasks

Needs are met by caregiver

Preconceptual

Toddler/Preschooler

2-4 years

Children imitate health behaviors that earn rewards.

If taught, child can carry out health-related tasks. Likes to practice behaviors.

Provide opportunities to master health-related skills.  Role model behaviors and reward imitation.  
Because of limited language, allow child to "play out" behaviors to learn child's perceptions.

Perceptual

Preschooler/Early School-age

4-7 years

Unable to perceive the whole, only "parts" of the whole. 

Health involves a series ("parts") of health practices.  Cannot consider cause and effect.  Health occurs when the child performs health activities--cannot be part healthy and part unhealthy at the same time.

Teaching should be related to child's own experiences.  Use teaching techniques that provide tactile, visual, auditory, and motor experiences.  Ask for feedback and correct misconceptions. 

Concrete Operational

Middle School-Age

7-11 years

Health is sense of physical a well-being, feeling good, or being in shape.

Can take initiative and participate in carrying out own health needs.  Has interest in health education.  Can consider risks and possible benefits of health behaviors.  Can be part healthy and part unhealthy.

Share health findings.  Use diagrams and models to make the invisible visible.  Teach the skill/procedure (tangible, concrete), then give rationale (abstract) in simple terms. 

Formal Operational

Late School-Age and above

11 years and above

Health is long-term physical, emotional, and social stability.  Brief illnesses may cause temporary instability.  Future health is considered.

Can assume full responsibility for health needs, make decisions, and carry them out. 

Inform of realities of health problems and the possible outcomes.  Peer teaching is more accepted.  Honesty is imperative.  Discuss the effects of health behaviors on the future.  Likes theoretical discussions and possible solutions and collaboration for management of needs.