"Nurses mediate the transitions, reveal the possibilities, mobilize the resources, negotiate the passages, guide the choices. Nursing becomes the work of connecting, interpreting, facilitating sense making, and meaningful world-negotiating approaches in regard to the ways we live in this world through our bodies”
(S. Smith, 1991, p.211).
Traditionally, client education has been done in a behavioral, rote, routine way. Content has been chosen based on a client’s specific diagnosis, or some other distinguishing feature. Education of any kind, including client education, should attend to the whole person and “....recognize that learning is subjective, contextual, dialogic and values-driven,” (Watson, 1988, p.1).
Client education is shifting from a “received knowledge” paradigm to a facilitative partnership between the nurse and the client. Nurses are becoming enablers, helping clients to practice self care and autonomy. Enabling includes coaching, informing and explaining, helping the client to generate alternatives, guiding them to think issues through and validating the client’s reality. Traditionally, prevention teaching has often been presented in a behaviourial self-disciplined context, which often led to clients ignoring the advice of the nurse or resenting any proposed lifestyle changes.
In order to make prevention - focused teaching meaningful, advice and teaching must be presented in a phenomenological way. The first step in phenomenological client education is to “be with” clients, engaging in dialogue, exploring the personal meaning of the client’s experiences and situatedness. Clients are viewed as beings for whom things have significance and value because of being situated, (Leonard, 1989). Given the same experience or situation, different interests and concerns will stand out for different people depending on their situatedness (Hartrick & Lindsey, 1995).
Clients are also constituted, are interpretive beings, who are always engaged in, and constituted by their interpretative understandings of their experiences. People’s backgrounds influence how they approach an experience and how they make meaning of it, including a learning experience.
To facilitate an understanding of each client’s preventative health education needs, nurses engage in dialogue to illuminate and reflect on patterns and themes within the client’s experience. Once they are identified, clients are assisted to imagine possibilities. From these realizations, unique learning needs can be identified.
Nursing knowledge of health and healing strategies is used to cultivate deeper levels of understanding and personal meaning. Phenomenological nursing illuminates the everyday taken for granted health patterns and discovers new patterns and ways of being to promote health and healing in ways congruent to the client’s preferred learning styles and strategies.
Now, client education can be facilitated with the use of technology. The world wide web has opened up an amazing store of data, information and teaching materials that anyone can access from the privacy of their own computer. Nurses can use these materials to augment other teaching provided to clients. Computers can also be useful to provide client education within the hospital environment – which can help to solidify the verbal teaching provided by busy nurses. Another innovation, kiosk-based education is also becoming popular – a means for people to access preventative and disease-focused educational programs in public areas, such as clinics, schools, shopping malls and libraries. Nurses can and should be involved in the design and writing of the content provided through any of these technological means.
Ends in View
This learning activity is intended to give the learner the opportunity to:
1. Engage in the process of phenomenological prevention education.
2. Create a unique learning tool to facilitate a selected client’s preventative learning.
3. Recognize the advantages and challenges inherent in using on-line and kiosk-based client education programs and initiatives.
4. Recognize their own learning needs in becoming proficient in using technology to create customized client education tools (web, brochures, booklets, Powerpoint, etc)
In Preparation
ENGAGE IN: phenomenological nursing inquiry to explore a specific client’s situatedness, constitutedness, personal meaning, patterns and themes and imagined possibilities related to their health experience and prevention awareness.
DIALOGUE: with your client to co-discover their perceived prevention education needs. Outline the themes to be addressed in the learning tool you will design.
The following Preparation activities include a few short readings related to the design of patient education materials, followed by some examples of electronically available patient education materials.
READ: Patient Education: An Author’s Guide for guidance on creating effective patient education materials. Topics include: Readability (SMOG formula); Clear writing; Literacy facts; Pre-testing, and more.
EXPLORE:Dr. Greene's House Calls NOTE: Dr. Greene is the Chief Medical Officer of A.D.A.M., the Founder & CEO of DrGreene.com, and the Pediatric Expert for AmericanBaby.com. He is on the Clinical Faculty at Stanford University School of Medicine where he sees patients and teaches Residents. He is a founding member of Hi-Ethics (Health Internet Ethics) and helped URAC develop its standards for eHealth accreditation.
EXPLORE: Healthy Habits to Help Prevent Flu (online brochures and posters). Department of Health and Human Services. Centers for Disease Control and Prevention.
EXPLORE:Lab Tests Onlinefrom the American Association for Clinical Chemistry.
1. Reflect on the patient education materials viewed in the Preparation section above.
Are these materials focused on the individual client?
How could they be made more personal?
What learning style(s) do they target?
Would you change them to address the needs of a Visual learner? How?
How about a Logical-Mathematical learner?
Kinesthetic or Musical learner?
How would you find out a client’s learning preferences (without testing their learning styles)?
2. Download the Client Education Planning Worksheet. Choose a topic that you would find valuable to teach patients, as well as an electronic venue to use for teaching. Outline the steps you would take to plan this initiative, following the headings in the left hand column. Save your work to help you with the following activities.
3. Using a computer system, create a learning tool for your specific client, incorporating the prevention education needs perceived in your preparation.
Possible approaches include:
a) Use a wordprocessing or desktop publishing program to create a pamphlet, handout, booklet.
b) Use a multimedia program to create a mixed text and images document.
c) Create a series of storyboards to sketch out the process of designing a Computer Assisted Instruction (CAI) learning experience for your client.
d) Create a Powerpoint slide show to illustrate and provide information related to your client's preventative learning needs.
Be Creative! Remember to target your client’s preferred learning methods.
Do they like to read? Prefer visuals? Videos?
When done, share your creation with your client, faculty, and peers.
4. The readings and preparatory exploration of various web resources present a variety of ways that technology can be used to provide content and visually rich client education materials. Discuss the technological mediums that impressed you, and share how you would personally use these mediums (given the time, money, competence) to teach clients, other nurses, and/or student nurses.
5. Considering the vast array of patient education materials available electronically (online, kiosks, DVDs, mobile apps, printed pamphlets, and so on), it is startling to see how little of the materials are actually written and designed by nurses. How can nurses be encouraged to become a more visible part of electronic patient education design? What is needed to make this happen?
In Reflection
1. How can a nurse engage in phenomenological prevention education within the busy existing health care system?
2. How could computer technology be used in health care settings to facilitate unique learning experiences for clients?
3. As you work with simulation, e-learning, online resource sites and other educational tools to augment your own learning (some are available in the campus labs) evaluate the scope of these programs. Would they be useful for client education?
References
Hartrick, G. & Lindsey, E.(1995). The lived experience of Families: A contextual approach to Family Nursing Practice, Pt. 2. Journal of the Family, 1 (2), p. 148-170.
Leonard, V. (1989). A Heideggerian phenomenologic perspective on the concept of person. Advances in Nursing Science, 11 (4), p. 40-55.
Smith, S. (1991). A Feminist analysis of constructs of health. In R. Neil and R. Watts (eds.) Caring and nursing: Explorations in feminist perspectives. New York: National League for Nursing, p. 209-225.
Watson, J. (1988). Curriculum revolution: Mandate for change. New York: National League for Nursing.
Nursing Informatics Integration for the BSN and BSN-AE Nursing Programs at Kwantlen Polytechnic University
Design & Content by June Kaminski, RN MSN PhD(c) - 1999 - 2021
All rights reserved. No reproduction without written permission
Traditionally, client education has been done in a behavioral, rote, routine way. Content has been chosen based on a client’s specific diagnosis, or some other distinguishing feature. Education of any kind, including client education, should attend to the whole person and “....recognize that learning is subjective, contextual, dialogic and values-driven,” (Watson, 1988, p.1).
Nursing knowledge of health and healing strategies is used to cultivate deeper levels of understanding and personal meaning. Phenomenological nursing illuminates the everyday taken for granted health patterns and discovers new patterns and ways of being to promote health and healing in ways congruent to the client’s preferred learning styles and strategies.
.