(d) Include the patient in planning. Ask his permission to involve family
members or others.
(2) Create a teaching plan. One nurse or several nurses can prepare and use
a teaching plan. There are standardized teaching plans available for major topics of health
teaching (some for computer use). Individualize the standardized plans to the patient's
needs and abilities.
(a) Match content with the appropriate teaching strategies and learner
activities. For example, content explaining why certain treatments and medications are
needed may be matched with printed or audiovisual materials. Children respond well to
teaching strategies that permit them to participate actively.
(b) Schedule teaching within the limits of time constraints. Shorter, more
frequent sessions allow the patient to digest the new information and prevents him from
becoming tired or uncomfortable due to his illness.
(c) Decide on group or individual teaching and formal or informal
teaching. Some learner objectives are met more readily in a one-to-one encounter (i.e.,
colostomy care) while others are met more easily in a group discussion with other patients
that have similar problems. Formal teaching is the planned teaching done to fulfill learner
objectives. Informal teaching occurs during nursing interactions with the patient and his
family. Informal teaching often leads to planned, formal sessions.
(d) Formulate a verbal or written contract with the patient. The contract
is informal and is not legally binding; however, such an agreement serves to motivate both
the patient and the nurse to attain the learning objectives. It points out the responsibilities
of both the nurse (teacher) and the patient (learner). Whether verbal or written, the
contract should not be intimidating, but viewed as an aid to learning. Failure to meet
contracted objectives should be redirected into new learning and decision-making
situations.
d. Implement the Teaching Plan. The implementation phase may be only a few
minutes or the sessions may extend over a period of days, or perhaps months. Use
interpersonal skills as well as effective communication techniques. Do not use technical
and medical terms unless the patient has a medical background, but avoid a
condescending attitude. Your attitude has a greater effect on the patient than any other
factor. If the patient must learn special techniques or procedures, tell him or her that it
takes time and practice to perform these new skills confidently. Review the contractual
agreement before implementing the teaching plan.
MD0906
7-10