Conceptual Bases of Professional Nursing Practice
The Seven Steps of Planning--Plus One
1: Variables Influencing Teaching and Learning
Effective teaching-learning interactions rarely just happen. Contrary to what some seem to think, teaching isn't magic; effective teachers plan carefully. There are a number of models one can use for developing teaching-learning interactions. One of these is the nursing process, but, since we use the nursing process all the time, I thought we'd look at another model, just for variety. The model we'll use is Jane Vella's model, called the Seven Steps of Planning. Vella is an adult educator with extensive experience in developing countries as well as in this country. She has written about her experience, describing her use of the seven steps of planning in a variety of settings.
So, what are those seven steps?
And, what's this in the title about "plus one" ?
I've added a step to Vella's
model to emphasize the importance
of planning for and conducting evaluation. Vella addresses evaluation
in Step 3, as you'll see when we talk about objectives and outcomes,
but it's been my experience that evaluation is often overlooked,
particularly in short-term, non-classroom situations. So, the table
gets another box.
Step 1 is about understanding the learner(s), and planning to best meet their needs. All the learner variables discussed in the previous section should be considered in step 1. These include: culture; developmental readiness; knowledge and skills relevant to the teaching-learning interaction being planned; motivation; physical and mental ability; and learning style. If you need to review any of these learner variables, return to the previous section.
Step 2 is about identifying learning needs. A simple way to approach this is to consider two types of learning needs: felt needs and analyzed needs.
Both felt needs and analyzed needs are legitimate, and both should be considered in most teaching-learning interactions. The relative weight of felt needs versus analyzed needs in shaping the interaction will vary, as will the degree of congruence between them.
It's important to remember that felt needs can be expressed directly and indirectly. Asking questions is the most common method of expressing felt needs directly. This is why it's so important to welcome questions and listen to them carefully. An effective teacher is also attuned to indirect communication of felt needs. This may take the form of indirect questions (I have a friend who needs some information about…) or non-verbal communication-voice tone, facial expression, behavior.
Finally, it's important to be aware of conflict between felt and analyzed needs. I've used this example before, but we've all experienced it, and it fits here too. For the majority of unlicensed nursing students, the overwhelming felt need is to learn about diseases and treatment and to learn "hands on" skills. On the other hand, educators analyze other needs like communication skills, application of research as a basis for practice, understanding of professional issues, etc. We all know what happens if content based on the analyzed needs is presented before the students' felt needs for disease knowledge and hands on skills are met.
Step 3 is about outcomes. In step 3 we decide what we want to accomplish through the teaching-learning interaction. Behaviorist theory gives us a good tool for communicating this-the behavioral objective. Since the use of behaviorist theory is so prevalent in nursing, you're familiar with behavioral objectives, but let's review a few key points. There are two sets of objectives involved in any teaching-learning situation, and we sometimes get them confused. One set of objectives is teacher objectives. Teacher objectives are what the teacher wants to accomplish; that is, the teacher's objectives for him/herself.
Teacher objectives are often overlooked, and may creep into the list of learner objectives. It's important that you, as a teacher, recognize your objectives and separate them from the learner objectives for the teaching-learning interaction.
The second set of objectives is learner (or learning) objectives. Learner objectives identify what the learner is to accomplish, or, put another way, outcomes of the educational activity to be demonstrated by the learner
Learner objectives may be identified by the teacher, the learner, or both.
Components of behavioral
One final comment about
behavioral objectives ...
You don't work on an objective until it demonstrates these characteristics; rather you work on it until it clearly communicates one of your intended educational outcomes.
Just in case you'd like a
different format ...
Step 4 is about content. This is where you identify content to address identified learning need(s) and facilitate desired outcomes. Then you organize and sequence it for delivery.
When you set out to identify content, it's important to consider potential content from all 3 domains of learning:
All teaching-learning sessions do not include content from all 3 domains. While it is often useful to include content from two, or even all three domains in one teaching-learning session, be careful about overwhelming or confusing the learner. In the case of the newly diagnosed diabetic, it would probably be both overwhelming and confusing if you tried to teach the disease treatment, pharmacology of Insulin and Insulin injection all in one session.
One pitfall often encountered by "nurse teachers", both in clinical practice and nursing education, is trying to teach too much. We know a lot about this stuff, and we usually find it interesting, so we try to teach everything we know. I'm sure most of you have heard this rule before, but here it is again. You must differentiate between the "need to know" and the "nice to know". No matter how much you love teaching stuff in the "nice to know" category, give it up unless:
Now that you've settled on the content, you need to break it into manageable units, and you need to sequence it. Sequencing should take into account both prerequisite information and skills and prerequisite levels of cognitive processing-if necessary, go back and review the section on cognitive learning theories and levels of cognitive processing.
In this step you'll need to think
about the learner(s), you as
the teacher, and the environment.
Considering the learner ...
Considering yourself as the teacher ...
Considering the environment ...
In this step, as in step 5, you'll need to consider the learner, yourself as the teacher, and the environment. Take a minute to identify a few examples of the kinds of things you should consider as you plan for where to conduct a teaching-learning session. Of course, sometimes you have no choice about the location, so the challenge is how to best use what you've got, if it's less than ideal.
This step is about teaching strategies. The term "teaching strategy" is teacher focused; if you prefer a learner focus, you might prefer the term learning activities. I will use "teaching strategies" here to underscore the fact that, in this case, you are the teacher. There are many teaching strategies available, ranging from more traditional strategies like lecture and print materials to less traditional strategies like gaming. The first step in choosing teaching strategies is to match the strategy to the domain of learning involved. The following table gives examples (not a comprehensive list) of teaching strategies best suited to each domain. Note that some strategies are appropriate for more than one domain. It's also important to remember that no strategy is inherently creative or effective-the design and implementation of a strategy in large part determines its creativity and effectiveness.
This is the step Debbie added, and it's about evaluation. We are often guilty of assuming that if we taught it, learning occurred. This is like assuming in other aspects of practice that if we did an intervention, the desired outcome happened --if we gave pain medication, the patient's pain was relieved. Well, maybe yes, maybe no. Evaluation involves collecting evidence. We must look for evidence that learning happened. There are two steps involved: identifying what evidence to collect, and deciding how to collect that evidence. Although behaviorism isn't my favorite learning theory, I must admit that good, clear learner objectives make the first step much easier. If you've written a good objective, it will tell you what evidence to look for to see whether that objective has been met.
The second step involves deciding how you will collect the evidence you need to determine whether or not the objective is met. In general, it is easier to collect evidence when the objective deals with lower level cognitive processes in the cognitive domain and/or can be achieved in a short time. The first objective in the example above illustrates this. The only decision you have to make is whether you want the learner to list the signs and symptoms verbally or in writing.
When meeting an objective requires some time and/or a change in setting, planning for how to collect the evidence becomes more challenging. The second objective in the example above illustrates this. In that example you have to decide whether you want/need to know whether or not your teaching was effective. If you do, you'll have to figure out a way to get information from those who follow-up with the patient (if it's someone other than you). In health care, we may often start teaching that won't come to fruition until the learner is in another setting and time has passed. In these situations it's particularly important to communicate clearly with providers who may be working with the patient in other settings.
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