1: Variables Influencing Teaching and Learning
| Another group
of system variables that affect
teaching-learning in nursing are those related to the agency or
organization in which you practice. Examples of agency/organization
- Organizational structure/roles
- Policies and procedures
Your organization's structure and people's roles within that structure
help determine who teaches what and when. For example, some
organizations have individuals whose job is teaching a particular
patient population, such as people with diabetes; or whose job is
teaching related to a specific event such as pre-op teaching or
discharge teaching. These "designated teachers" have a variety of
titles including clinician, clinical specialist, and educator. When an
organization has "designated teachers", that person has the primary
responsibility for teaching specific patient population(s) or subject
matter, and the staff nurses' teaching role becomes more supportive,
focusing on review and reinforcement. In contrast, in many
organizations, teaching is the responsibility of the nurse(s)
responsible for the patient's overall care. For example, in home health
each nurse has responsibility for teaching the patients and family's in
his/her case load. Clarity concerning roles and responsibilities, and
effective communication among all those with responsibility for
teaching are key to making any system work.
Thinking about your experience
- Who has responsibility
for teaching what in your
current practice setting? Are roles and responsibilities clear? Do
those with responsibility for teaching communicate effectively with
- What works well in your
setting? What are the
problems in your setting?
- How does your past
experience with teaching differ
from your current situation?
- What structure do
you think best facilitates
effective teaching as a part of nursing practice?
Policies and Procedures
Many agencies have policies and procedures to direct teaching and
learning in that setting. Policies and procedures may be derived in
part from standards of practice, and usually address rules and process:
who teaches; when teaching should be done; how to get teaching
materials approved; how to document teaching; etc. Policies and
procedures may address teaching materials, but are not the same. For
example, a policy may include rules for developing and/or using
educational pamphlets, but the pamphlets themselves are not part of the
policy or procedure.
| Thinking about your experience ...
- Are you familiar with policies and procedures
governing teaching in your setting?
- How do your agency's policies and procedures
facilitate teaching as part of your practice? How do they impede
teaching as part of your practice?
- If you were on a committee assigned to review and
revise your agency/unit's policies and procedures, what suggestions
would you make?
The quantity and quality of resources available to support teaching and
learning certainly influence the character of teaching-learning
interactions, and can decrease their effectiveness. Resources generally
boil down to money, and this is no exception. Examples of resources
that money can buy include:
As we know, resource allocation
reflects priorities. This is
the case with individuals and organizations. Incongruence between
stated priorities and resource allocation can be frustrating, as can
incongruence between individual and organizational priorities. It may
be safe to say that most of us want our organizations to value teaching
as much as we do, and we want them to "put their money where their
Certainly adequate quantities of
excellent resources offer
more options and make teaching easier. However, it is important to
remember that teaching-learning interactions can still be effective
when resources are limited. Skill, creativity, and flexibility can
overcome some resource limitations.
| Thinking about your experience ...
- How would you rate the quantity and quality of
resources for teaching in your agency?
- How does teaching rank in your priorities regarding
practice? How does this compare with the priority your agency places on
- What strategies have you used or seen used to make
teaching effective in spite of limited resources?
- What strategies have you used or can you think of to
get additional resources for teaching?