Evaluation and Documentation
The Roberta Straessle Abruzzese (RSA) model consisting of “process, content, outcome, impact, and total program evaluation” was used as a framework (Bastable, 2017, p. 601). Process and content evaluation were used for this teaching session.
For process evaluation, the educator used a method of observation to evaluate this session concurrently while the learning experience occurs. How did Mr. Tan respond to teaching methods and materials? How about the environment? Was the temperature, lighting, space appropriate for Mr. Tan? Allow him to express any concerns if problems arise to make relevant adjustments (Bastable, 2017, pp. 603-614).
For content evaluation, use behavioural objectives set before as guidance, and Teach-Back method to evaluate Mr. Tan’s knowledge and a skill learned. Teach-Back method is an evidence-based approach for quality education (Kornburger et al., 2013; Tamura-Lis, 2013). Mr. Tan was required to state in his own words what hypoglycemia symptoms are and what to do when the situation arises, to provide valuable information that the educator has explained well, and to confirm he understands what being taught.
Mr. Tan also performed a return-demonstration using the same equipment provided and performance checklist to confirm that he is capable to check his own blood glucose level accurately. The analysis of evaluation results provided information about how well Mr. Tan had achieved his learning outcomes and served as guidance that provides directions for future teaching project planning (Bastable, 2017).
At the end of this teaching session, the nurse provided the learning materials used to Mr. Tan with an E-mail address at the bottom for the convenience of communication (Bastable, 2017, p. 574). The nurse also provided online support group resources to Mr. Tan as it helps in improving self-care and members with the same conditions can provide emotional support to each other (Mullin, 2010; 1978) which is essential to achieve optimal education outcomes as Mr. Tan is viewed as active participants of the entire education process instead of adopting a passive role.
The one-to-one instructional method that actively involves Mr. Tan, with face-to-face communication is useful in reaching the cognitive learning outcome and has a positive effect on patient education (Bastable, 2017). Therefore, this teaching method was chosen for the cognitive domain.
Rotter’s model of locus of control (1966) revealed that individuals view their health either related to their own behaviour or external factors. Mr. Tan viewed that he has a responsibility for his own health, his locus of control is internal and therefore, he controls his health. This belief was further enhanced by improving his own confidence and capacity in performing self-care through the application of Bandura’s self-efficacy model (1977).
When implementing the plan, the nurse encouraged and provided positive reinforcement, meanwhile Mr. Tan can obtain intrinsic feedback within himself which will improve his confidence in finishing this learning task (Lorig, 2003). The educator tried to vary the tones, mind the facial expressions and gestures to facilitate the process of conveying messages in a culturally safe way (Bastable, 2017, p. 490).
As for psychomotor learning, demonstration and return demonstration method are very effective ways of teaching this domain (Bastable, 2017). Therefore, this method was selected with computer access to play a demonstration video to learn how to check blood glucose levels with the hyper-count machine. When watching the demonstration video, the nurse educator assisted Mr. Tan in dividing it into meaningful small parts to learn sequentially (Lorig, 2003). According to Bandura’s self-efficacy model (1977), providing praise along the way improves learner’s confidence in being able to perform the task. Mr. Tan’s wife, Mia also provided support when Mr. Tan was performing the skills required. Repeated practice is essential to master this skill.
Part B: Introduction
Assessment is the first step in planning an education session (Kelo, Eriksson, & Eriksson, 2013). It includes an assessment of learning needs, readiness, and motivation to learn, learning styles, literacy plus cultural and ethical considerations. The next step is planning and implementation, followed by evaluation and documentation (Bastable, 2017).
Based on the Knowles Adult learning theory, adult learners have the autonomy to decide what they want to learn and with the observed popularity of using computers, patients enter in the education process not only with their previous rich life experiences (Knowles, 1980) but also with the health-related information they searched online at hand. Nurses become facilitators during the education process with learner at the center (Andrews & Ford, 2013). Therefore, it is the educator’s task and ethical practice to respect Mr. Tan’s autonomy, to assess and identify what he has already known and what he wants to learn.
Questions asked to Mr. Tan during the assessment interview include “May I know what you have already known about the Type 2 DM?”, “What useful information have you found on the internet recently?” , “What area about Type 2 DM that you want to know most?”, “What are your goals in the education session?”. Under limited timeframe, the nurse also collaborated with other healthcare providers who were also taking care of Mr. Tan for more information as well as checked the medical records for updated information (Bastable, 2017, pp 122-127; Sopczyk, 2017, p. 558).
Mr. Tan had basic knowledge about what Type 2 DM is and he was keen to learn the mandatory survival needs including what symptoms of hypoglycemia are and how to handle it.