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STRATEGIES IN HEALTH EDUCATION Ms. Lorelie Singson-Doblado,R.N.,M.A.N. Thursday to Friday/9:30-11:00 am August 27, 2009

PREPARED BY:

Eduardo L. Alcantara Katrina Jane S. Ardales Danica D. Gatchalian Honey Faith T. Baarde Maricar A. Navarro OBJECTIVES: At the end of the 1 hour lecture-discussion, the students will be able to: I. Cognitive: KNOWLEDGE: Define and describe what are activity-based teaching strategies. COMPREHENSION: Classify the teaching strategies into four categories. APPLICATION: Apply this teaching strategy. ANALYSIS: Contrast it with the previous teaching strategies. SYNTHESIS: Create new way of teaching strategies focusing on activity-based teaching strategies. EVALUATION: Evaluate the relevance of the said teaching strategies. II. Psychomotor: Organize a group and apply one of the activity-based teaching strategies. III. Affective: Integrate Christian values. ACTIVITY-BASED TEACHING STRATEGIES

Activity implies active learning on the part of the learner. All of the strategies discussed in this chapter- cooperative learning, simulations and games, case studies, problem-based learning, and self- learning modules- require the learner to do more than listen and study. Learners engaged in these strategies are involved in creating and storing up knowledge for themselves.

o COOPERATIVE LEARNING - Cooperative learning is not new. It is based on the premise that learners work together and -

are responsible for not only their own learning but also for the learning of the other group (Lindauer and Petrie, 1997). A working definition of cooperative learning is that involves structuring small groups of learners who work together toward achieving shared learning goals.

Types of Cooperative Learning Groups - Cooperative learning groups can be structured in various ways. The basic configurations are termed formal groups, informal groups, and base groups.

Purpose

Length

FORMAL GROUPS -To complete a specific learning task consisting of concepts or skills.

INFORMAL GROUPS - To enhance understanding of a specific unit of information; to make connections to prior to learning.

BASE GROUPS - To provide encouragement and to monitor progress throughout the learning experience. - The length of the

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of existenc e

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- One class to many weeks

- No more than one class and perhaps for only a few minutes during a class.

learning experience; usually long-term

You may set up a formal cooperative learning group in a nursing research course, for example, if you assign groups of students to develop a proposal for a clinical research study. Group learning can be measured by evaluating the finished project and asg a group grade. Formal cooperative learning is probably most useful in academic settings rather than in service or patient education situations. Informal cooperative learning groups can be used in any setting. An application in patient education would be a situation where you are teaching about the childbirth experience to a group of parent-to-be. Base cooperative learning groups could be applied easily to new staff orientation or preceptorship programs.

Advantages of Cooperative Learning 1. Group learn to function as part of a team. 2. Working in a group for any length of time can teach or enhance social skills. 3. Cooperative learning groups can help to address individual learning needs and learning styles. 4. Cooperative learning is the fact that critical thinking is promoted. There are really no disadvantages to cooperative learning, except the belief that if you use class time in cooperative learning, you won’t be able to “cover all the content.” Research on Cooperative Learning 1. It produces higher achievement levels than do individualistic or competitive learning approaches. 2. Outcome measures of achievement are knowledge gain, retention of knowledge, problem solving, reading, mathematic, and procedural tasks, all of which show increases with cooperative learning. 3. Other outcomes found are increased self-esteem, improved attitude toward learning, social competence, and decreased anxiety in learning. 4. Cooperative learning has been found to be cost-effective strategy. 5. Effectiveness of cooperative learning has been found in all age groups and levels of education, both sexes, all nationalities studies, and all economic groups. 6. Effects have been equally good for all learners at all ability levels.

o SIMULATIONS Simulations are controlled representations of reality. They are exercises that learners engage in order to learn about the real world without the risk of real world thereby it adds fun. There are 4 types of simulations namely: simulation exercises, simulation games, roleplaying and case studies. Simulation exercise is a controlled representation of a piece of reality that learners can manipulate to better understand the corresponding real situation. It primarily focuses on process learning. Participants learn how to make decisions, solve problems or application of theory. Many organizations apply this process like for instance Wildman and Reeves (1997) used a simulation exercise to teach nursing students how to apply management theories to organize the work of a hospital clinical unit. It is designed to help learners apply and master psychomotor and clinical skills. Simulation games focus on either content or process learning. Content games focus on teaching or reinforcing factual information. Crossword puzzles and Bingo games are examples that

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aim to teach terminology and help previously learned facts. Process learning emphasizes problemsolving or application of information. An example of simulation game is SimCity described by Bareford (2001) as the use of computer program to help nursing students apply critical thinking skills to community assessment and planning. An advantage of using simulation games to teach facts and application of information is that gaming is, for most people means fun. One of the best advantages of the gaming approach is that it increases interaction among learners and allows even quiet and reserved class to participate in a relatively low-risked situation. Games are also appropriate in adult learning because they are the best when they see relevance of information, when they are actively involved in the learning process and when they can apply problem-solving methods, games which meet all of these goals. Another type of simulation is role-playing which is a form of drama in which learners spontaneously act out roles in an interaction involving the play, the participants do not have script to follow and no rehearse because they are given only a written or verbal explanation of the simulated situation and are expected to have enough general knowledge about the situation. This teaching method is effective in helping people gain skill in interpersonal conflicts. It is a means of helping people develop the quality of empathy and to understand social problems of groups of people. Role-playing scenarios last only about three to five minutes. It has long been used to teach therapeutic communication skills. The last type of simulation is case studies. It is an analysis of an incident or situation in which characters and relationships are described, factual or hypothetical evens transpire, and problems need to be resolved or solved. Case studies can be used successfully to apply principles discussed in class, to encourage independent study and critical thinking and to safely expose learners to real world situations they will encounter in the future. When you would like to provide learners with certain decision-making clinical experiences but cannot do so for various practical reasons, a case study can be used to provide at least part of that experience vicariously. Case study can range from the simples and short to complex and lengthy. The purpose and uses of simulations is to help learners practice decision-making and problem-solving skills, to develop human interaction abilities, and to learn psychomotor skills in safe and controlled settings. Learners have a chance to apply principles and theories they have heard or read about and to see how and when these principles and theories worded. In one venue, a nursing student may have learned about the nursing process from a series of lectures in audiovisuals, but the process make a lot more sense after the student applies it in a simulation case study drawn from the real world. An advantage of the simulation method is that simulation is usually worked out in by group of learners. Since teamwork is the essence of nursing practice this correlation to the work world is valuable. Simulation is also an avenue for attitude change. Constructive attitudes can lead to more productive and acceptable behavior. Finally, simulation can be used to evaluate learning and competencies. The educator’s role is simulation has three facets: planning, facilitating and debriefing. Planning begins with choosing or developing an appropriate simulation that will meet learning objectives. In the facilitating function, the learners act as facilitator during the actual progress of simulation. The most important part of the role is the final discussion or debriefing session. Debriefing should occur immediately following the simulation when the information is fresh. First, briefly summarize what had taken place, it can be valuable to have the learners explain what they did and why. Third, you should point out how principles and concepts have been applied and how the experience ties in to the learning objectives.

o PROBLEM-BASED LEARNING -It is an approach to learning that involves confronting students with real-life problems. -It is based on the premise that students:  Working together in small groups  Analyze a case  Identify their own needs for information

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PBL and Case Studies has differences which are the ff: PBL CASE STUDIES Conducted with a small group. May be individualized or with a group. Students have little background Students have the most knowledge of the subject background knowledge matter in the case. they need to apply. PBL grew out of a sense of frustration:  When students are first introduced to PBL, they may be unhappy with the role and that of the teacher. Some students feel that they are doing all the work, and they experience frustration as they learn to direct their own learning. PBL unit would go something like this: a class of 20 undergraduate senior nursing students is going to use PBL to several learning units in a leadership course. After few weeks of some lecturediscussion classes on general leadership theory, the first problem is given to them. The problem is: A small community hospital is confronted with a severe nursing shortage. They are considering a change in the nursing care delivery system to a model that involves cross-training of personnel and increased used of assistive personnel. Rumors about a change begin to circulate around the hospital and many staff seems unhappy. They brainstorm as to what the key concepts are in the problem description and may develop a list of “what we know” and “what we don’t know”. Learning issues: 1. Nursing Shortages a. How often they occur? b. How severe do they get? c. What causes them? 2. Nursing care delivery system a. What is this one called? b. Is it being used anywhere? c. How would it work? 3, Can we predict how people respond to change? a. How can change be handled? b. How should the leader deal with the rumors? c. Is there any way to predict whether this would be a good change? The list of what we know is updated. The learners will brainstorm about the problem and if they feel ready, they will write the problem definition and begin o develop hypotheses as to causes of the problem.  There are several reports that found PBL to be atleast as effective or more effective than traditional method.  Researchers are even more confident that PBL is motivational and enjoyable and that learners are more satisfied with their educational experience than students in traditional classroom. Celia and Gordon (2001) have reported one of the first application of PBL to staff development in their use of problems to enhance novice nurses  Ability to think critically;  Ant to prioritize patient care

o SELF-LEARNING MODULES

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- a.k.a. self-directed learning modules, self-paced learning modules, self learning packets, and individualized learning activity packages. - a self contained unit or package of study materials for use by an individual Self-directed learning is based on some of the principles of adult learning such as: 1. Adults are self-motivated to learn material for which they see relevance. 2. Adult’s prior experience is a resource for further learning. 3. Adult’s are problem focused and readily learn material they can use to solve problems. COMPONENTS OF SELF- LEARNING MODULES • Introduction and instructions • Behavioral objectives • Pre test • Learning activities • Self-evaluation • Post test •

INTRODUCTION AND INSTRUCTIONS -tells the learner how to work through the module, how to use the pre test and selfevaluation guides, where to locate resources, what procedures to use for handing in assignments or scheduling skills test and what are the roles of the educator and learner are.

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BEHAVIORAL OBJECTIVES -express in clear language, what the learner will be able to do on completion of the module.

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PRETEST - Include questions about the main topic - Also include some questions that assess knowledge of the content of the module itself. LEARNING ACTIVITIES -make up the most creative portion of the self-learning module -designed that will help the learner achieve the objective -activity should also appeal to people with differing learning styles.

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SELF-EVALUATION -usually included at the end of every lesson or sub concept -generally some form of quiz, either multiple choice questions or short answer questions.

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POST TEST - Used to determine whether learners have mastered module objectives

DEVELOPING A MODULE -Plans should be undertaken weeks or months before it will be needed. ADVANTAGES -ability to learn independently in one’s own time -promote active learning and provide immediate on performance DISADVANTAGES -Some learners may miss learning with other people and may miss the interactions that take place in a classroom. -in settings where the module post test is taken without supervision, learners may be less than honest about their result and thus forgo needed learning. -modules take many hours to design and test

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RESEARCH ON EFFECTIVENESS  NIKOLAJSKI(1992) -compared module used in classes with lecture/slide presentation and found that both groups had significant learning gains, but the gains were greater for lecture group.  LAMB AND HENDERSON (1993) -found that in comparing groups given lectures versus those using modules, the module group had significantly higher post test score.  

GRANT(1993) -found that nurses preferred to use module rather than attend lecture classes. LIPE and COLLEAGUES (1944) -reported 95 to 100 percent favorable evaluations among nurses who learned from modules.

Source: DeYoung, Sandra (2003) Teaching Strategies for Nurse Educators. Published by Pearson Education,Inc. Pages 141-165

There is a physical, not moral, impossibility of supplying the wants of the intellect in the state of civilisation at which we have arrived. The stimulus, the training, the time, are all three wanting to us; or, in other words, the means and inducements are not there. Look at the poor lives we lead. It is a wonder that we are so good as we are, not that we are so bad. In looking round we are struck with the power of the organisations we see, not with their want of power. Now and then, it is true, we are conscious that there is an inferior organisation, but, in general, just the contrary. -Florence Nightingale (1820-1910)

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