The next step in the process is to plan and implement an individualized teaching plan. Your teaching plan should include what will be taught, when teaching will occur, where teaching will take place, who will teach and learn, and how teaching will occur. Deciding what will be taught is a decision you and the patient need to make together. Although you begin as the content expert, your goal is to make your patient as competent as he needs to be to manage his or her own health care needs. Start by looking at the information that the patient needs to know and distinguish between what the patient „needs to know“ and what is „nice to know.“ Start with the „need to know“ information and let the patient select where he or she wants to start.
Here are two excellent books on teaching content for a variety of health care conditions:
- Nurse’s Handbook of Patient Education, by Shirin F. Pestonjee (2000, Springhouse).
- Mosby’s Handbook of Patient Teaching, by Mary Conobbio (2000, Harcourt Health Services).
Plan when you will teach, taking the length of hospital stay or number of home health visits available into account. Let the patient tell you what works for him or her and offer as many options as are realistic. Does the patient prefer mornings or have more energy in the evening? Does he or she like short sessions or longer, more in-depth sessions? As you implement your plan, assess how quickly the patient can learn information. During teaching sessions, ask the patient to tell you when he or she is tired and watch for signs of fatigue such as yawning, inability to concentrate, or inattentiveness. Keep teaching sessions relatively short-generally no more than 30 minutes and possibly as short as five minutes. Plan on being able to grab those precious „teachable moments“ when the patient is ready to learn-even when it means throwing your planned timetable out the window.
Plan where you will teach, including considering both comfort and privacy. If the patient may become upset or you must ask intimate questions, find an empty room, wait until the patient’s roommate has left for a while, or use an empty treatment room or office. Whatever setting you use, make sure you try to limit distractions and interruptions. Plan who will teach and who will learn. Will you be the primary teacher or will other health care professionals be involved? Former patients who have been through a similar experience can be helpful. The American Cancer Society has shown that having other patients visit through its „Reach to Recovery“ program can provide breast cancer patients with much needed hope and motivation. You may be teaching people other than the patient, such as a spouse, another caregiver, or a friend or neighbor.
Plan how you will teach. Use data from your assessment about the patient’s preferred learning style to select the method. Remember that global learners like to understand the big picture first and work down to the details. Linear learners want the details first and then expect a bigger picture to emerge. As an example, when teaching a global learner how to do home blood glucose monitoring, you might start with the overall purpose of monitoring and then go on to details. If your patient is a linear learner, start with the first procedure that patient needs to know to operate the machine and end with the bigger picture. If your patient indicated on the assessment that he or she is a visual learner, select teaching materials that involve reading, writing, and watching visual media such as videotapes and slides. Auditory learners need to hear information via spoken explanations and audiocassettes, and they may remember information better in pamphlets if they hear it read aloud. Tactile learners must touch, manipulate, and perform a task to learn. Tactile learners often remember more when they can touch and handle equipment, and they may recall written information best by underlining or highlighting. Table 5 shows some of the teaching methods and materials you may use, depending on the patient’s preferred learning style and which methods and materials are most appropriate for specific situations.
Examples of Methods and Materials
Source: Boyd, M.D. (1998). „Strategies for effective health teaching.“ In: Boyd, M., et al. Health Teaching in Nursing Practice, 3rd ed. Stanford, Conn.: Appleton & Lange, 201-228.
Whenever possible, select interactive teaching methods that use as many senses as possible. Keep in mind that patients remember approximately 10 percent of what they read, 25 percent of what they hear, 45 percent of what they see, 65 percent of what they hear and see, 70 percent of what they say and write, and 90 percent of what they say as they perform a task.