Health education and adult learning

Professor Tarek Tawfik Amin

Public Health

Cairo University amin55@myway.com

Objectives:

At the end of the session, trainees would be able to:

1- Define the basic rules for providing health education.

2- Get oriented with principles of adult learning.

3- Appreciate the practical roles for processes

involved in adult learning.

Principles of Patient Education

People are expected to learn enough about their own health to be able to participate in health care decisions.

Patient education has changed from telling the subject the best actions to take, to assisting them in learning about their health care for the sake of improvement.

Racial, cultural and ethnic differences play a large part in the communication process.

Principles of Patient Education

Two important principles for providing patient education are simplicity and reinforcement.

"Simplicity" means that educational messages must be delivered so the subject can readily understand them.

Health education can include extremely intricate information (e.g., triple screening, amniocentesis, and Rh incompatibility).

Principles of Patient Education

Start by assessing what the subject knows before teaching.

Never assume that the patient needs to be taught everything about a topic.

Over teaching must be avoided. It is far better to choose three or four

essential concepts about a topic.

Principles for Providing Patient Education

Simplicity

1.Teach the simple concepts about a topic first, and then move to the more complex concepts.

2. Use language that the woman will find easy to understand and avoid medical terminology whenever possible.

3. Use words that mean something to the general public. The word "positive" has a good connotation for most people, but in health issues, sometimes "positive" means a bad finding; this can be very confusing for our patients.

4. Use concrete language and tell them exactly what you want them to do, such as "call me if you feel any fluid leaking from your vagina," not "call me if your water breaks."

Principles for Providing Patient Education

Reinforcement1.Teach the one concept you want your subjects to truly learn first in the lesson, and then teach that same concept again last.

2. Ask subjects to re-state what you have taught them, so you can be sure they understood.

3. Use visual aids for teaching; using several senses improves learning.

4. Always use written educational materials for the subjects to take home.

Knowles adult learning principles

Knowles formulated what he called the "Adult Learning Principles".

They remain today essential knowledge for people who teach adults in health settings.

These adult learning principles can help us to plan effective health education programs.

Knowles adult learning principles

1. Adults learn best when there is a perceived need.

2. Progress from the known to the unknown. 3. Always assess what they know about a

topic before beginning a teaching session. 4. Don't re-teach the things they already

understand.5. Progress from the simpler concepts to

more complex topics. 6. Adults learn best using active

participation.

Knowles adult learning principles

7. Adults require opportunities to practice new skills.

8. Adults need the behavior reinforced. Teaching about health topics needs reinforcement continually.

9. Immediate feedback and correction of misconceptions increases learning.

10.Always ask the subject to restate what you have taught.

Adapted from Knowles, 1980

Adult-Learning Principles Introduction

o Knowles also described adult learning as a process of self-directed inquiry.

o Six characteristics of adult learners were identified by Knowles (1970).

o He advocated creating a climate of mutual trust and clarification of mutual expectations with the learner.

Characteristics of adult learners

ΩAutonomous and self-directed

ΩAccumulated a foundation of experiences and knowledge

ΩGoal oriented ΩRelevancy oriented ΩPractical ΩNeed to be shown respect

Knowles 1970

Adult-Learning Principles Introduction

The reasons most adults enter any learning experience is to create change.

This could encompass a change in (a)their skills, (b)behavior, (c) knowledge level, or (d)even their attitudes about things (Adult

Education Centre, 2005).

Adult-Learning Principles Introduction

Compared to school-age children, the major differences in adult learners are in:

a) the degree of motivation, b) the amount of previous experience, c) the level of engagement in the learning

process, and d) how the learning is applied. Each adult brings to the learning experience

preconceived thoughts and feelings that will be influenced by each of these factors.

Assessing the level of these traits-readiness should be included each time a teaching experience is being planned.

Pillars of adult learning .

Adult Learning

Motivation Experiences Engagement

Adult-Learning Principles 1- Motivation

o Adults learn best when convinced of the need for knowing the information.

o Often a life experience or situation stimulates the motivation to learn (O'Brien, 2004).

o Meaningful learning can be intrinsically motivating.

Adult-Learning Principles 1- Motivation

o The key to using adults' "natural" motivation to learn is tapping into their most teachable moments (Zemke & Zemke, 1995).

o Lieb (1991) described six factors which serve as sources of motivation for adult learning.

Sources of motivations

1. Social Relationships: to make new friends; to meet a need for associations and friendships.

2. External expectations: to comply with instructions from someone else; to fulfill recommendations of someone else with full authority.

3. Special welfare: to improve ability to serve mankind; to improve ability to participate in community work.

4. Personal Advancement: to achieve higher status in a job; to secure professional advancement.

5. Escape/Stimulation: to relieve boredom; provide a break in the routine of home or work.

6. Cognitive/interest: to learn for the sake of learning to satisfy an inquiring mind.

Leib, 1991

Motivation

Health care providers involved in educating adults need to convey a desire to connect with the learner.

Providing a challenge to the learner without causing frustration is additionally important.

Above all, provide feedback and positive reinforcement about what has been learned (Lieb, 1991).

Experience

Adults have a greater depth, breadth, and variation in the quality of previous life experiences than younger people.

Past educational or work experiences may color or bias the patient's perceived ideas about how education will occur.

Former experiences can assist the adult to connect the current learning experience to something learned in the past.

This may also facilitate in making the learning experience more meaningful.

(O'Brien, 2004).

Experience

However, past experiences may actually make the task harder if these biases are not recognized as being present by the teacher.

This would be an opportune time to address any erroneous or preconceived ideas.

Level of Engagement

When an adult learner has control over the nature, timing, and direction of the learning process, the entire experience is facilitated.

Adults have a need to be self-directed, deciding for themselves what they want to learn.

They have a goal in mind and generally take a leadership role in their learning.

The challenge for teachers is to encourage the learner with reinforcement.

Rogers (1969)

Level of engagement

According to Rogers (1969), the adult-learning process is facilitated when:

1. The learner participates completely in the learning process and has control over its nature and direction.

2. It is primarily based upon direct confrontation with practical, social, or personal problems.

3. Self-evaluation is the principal method of assessing the progress or success.

Level of engagement

It is important to remember that in order to engage the adult learner and facilitate the transfer of knowledge, patience and time on the part of the teacher and patient are needed.

Applying the Learning: readability

o Verbal patient education should always be accompanied by written information.

o It can be difficult to find information written at the appropriate readability level, containing the appropriate information, and in the language the woman understands.

Readability

o Health education materials developed for the general public should not exceed sixth to eighth grade levels.

o Materials written at readability levels of sixth to eighth grade are more effective in conveying health messages and have higher rates of recall across all educational levels.

Readability

o Some populations of women have specific problems with written health education materials, especially women with low literacy skills.

o It is clear that women with low literacy skills require special interventions to help them learn.

Readability

o Educational materials given to clients should be culturally competent.

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Thank you