THE NATURE OF THE LEARNER

 HUMAN DEVELOPMENT – is the

dynamic process of change that
occurs in the physical, psychological,
social, spiritual and emotional
constitution and make up of an
individual which starts from
CONCEPTION to DEATH.
 Changes may entail:
 GROWTH – which is quantitative
involving increase in the size of the
parts of the body
 DEVELOPMENT – which is qualitative
involving gradual changes in
character
Two Major Processes that takes
places during growth and
development:
LEARNING – a complex process which involves
changes in mental processing, development of
emotional functioning and social development
skills which develop and evolve from birth to
death.
MATURATION – includes bodily changes which
are primarily a result of heredity or the traits
that a person inherits from his parents which
are genetically determined, preprogrammed
inherited biological patterns are reflected in
maturation.
 PERIODS OF LIFE SPAN
DEVELOPMENT
 Prenatal Development – includes the time
from conception to birth, from single cell to
an organism complete with brain and
behavioral capabilities produced in 9
months ( 270-280 days or 40 weeks).
 Heredity – is the sum total of characteristics
which are biologically transmitted thru
parents to offspring. These characteristics
are determined by the genes which are
made up of DNA which determine the
hereditary characteristics which are found
in the chromosomes.
 Chromosomes – are found in the nucleus of
each cell which contains the GENES
 Infancy
 extends from birth up to 18 to 24 months,
characterized by time of extreme dependence on
adults , babyhood and the beginning of many
psychological activities like language, symbolic
thought, sensorimotor coordination and social
learning.
 Sensorimotor development – head turns to
direction of touch, lifts chin and head, hold head
erect, reaches for objects, sits with support, stands
with help, crawls, and walks with support.
 Early Childhood
– begins from the end of infancy to about 5-
6 years which is sometimes called “ Pre-
School Years”.
 Become more self – sufficient and care for
themselves
 Develop school readiness skills like identifying letters
and following instructions.
 Spend many hours in play with peers
 How the child’s Pre- school experiences affects
his growth and development:
 If physiological and psychological needs are met,
the child develops a healthy and pleasant
personality
 learns to communicate and develop
understanding of himself and his environment
 the quality of the interaction between the child
and parents affects the child’s own attitude.
The relationship that the child has with the “Significant Others”
who are in constant touch and contact with the child will
determine the child’s self –esteem or self concept like:

 if the child thinks he/she is loved through the

stimulation and nurturance that is given to
him/her, the child develops high self-esteem
which makes the child enthusiastic and open to
experiences.
 if the child feels not accepted and not cared for,
he /she develops confusion, fear or inferiority
complex.
Middle and Late Childhood (School Age)

This is the period where:

 The fundamental skills of reading, writing and
arithmetic are mastered; and
 When the child is formally exposed to the world
and its culture, he/she becomes more achievement
centered with increased self – control.
 Adolescence
 – Marks the transition from childhood to
early adulthood; approximately from 10-12
years and ending at 18-22 years old.
 -Where full physical development is
achieved.
 Puberty – marked by the development of
sexual characteristics
 Pursuit of independence and an identity is
prominent
 Thoughts are more logical, abstract and
idealistic
 More time is spent outside the family
 More marked internal than external
development during later adolescence
 Spends more time with the physical looks and
improving appearance
 Early Adulthood
 begins in late teens or early twenties
through the thirties. It is a period of:
establishing personal and economic independence
career development
selecting a mate
intimate relationships, and
starting a family
 Middle Adulthood
 from 35-45 years old up to 65 years old. It is
characterized by:
menopause for women
climacteric or andropause for men
time of expanding personal and social
involvement and responsibility, assisting next
generation in becoming competent
 Late Adulthood
 Or senescence, begins from 65 to 80 years
old and lasting until death
time of adjustment to decreasing strength and
health
life review
retirement
adjustment to new social roles
affiliations with members of one’s age group
 FOUR THEORIES OF HUMAN
DEVELOPMENT
 1.Psychosexual Development Theory
 Sigmund Freud – the Father of Modern Psychology,
believed that human beings pass through a series of
stages that are dominated by the development of
sensitivity in a particular erogenous zone or pleasure
giving area in the body.
 The person must be able to resolve the conflicts that each
stage poses before he can move on to the next higher
stage. Failure to resolve the conflict results to frustration
and the individual may become so addicted to the
pleasure of a given stage that he develops fixation and
fails to move on to the next higher stage of development.
 Erikson’s Psychosocial Stages of
Development
 Each stage has a major developmental task or dilemma
that must be resolved … the individual is presented with a
crisis he must resolve.
 Crisis – a turning point, crucial period of increased
vulnerability and heightened potential. The individual
develops a “ healthy personality” by mastering life’s outer
and inner dangers.
 Epigenetic principle – personality continues to develop
throughout the entire life span. Each part of the
personality has a particular time in the life span when it
must develop, if it is going to develop at all.
 Eight Major Stages of Social –Emotional
Development
 Infant : Trust vs. Mistrust - needs of
infant must be met by caretakers who are
responsive and sensitive… infants must be
cuddled and fondled.
development of trust results into a sense of safe
and dependable place
non- resolution may develop into mistrust and
fear of the future and a suspicious mind.
 Toddler
 Autonomy vs. Shame and Doubt - as a child
begins to crawl, walk and explores his
surroundings, the conflict is whether to assert
their wills or not.
resolution : children acquire sense of independence and
competence when parents are patients and
encouraging.
Non – resolution : children develop excessive shame and
doubt when parents are overprotective and always
curtail their child’s freedom of movement.
 Pre- school
 Initiative vs. Guilt – development of
mental and motor abilities
resolution : children will develop initiative if
parents allow them freedom to run, slide, play
with other children, go bike riding etc.
non- resolution: children develop sense of
inadequacy and feel that they are mere
intruders or “ istorbo” and “ pasaway”; they
become passive recipients of whatever the
environment brings.
 School Age
 : Industry vs. Inferiority - child’s concern is ‘
how things work” and how they are made.
resolution : children gain a sense of industry or
accomplishment if their efforts are recognized,
rewarded and reinforced.
Non-resolution: children acquire a sense of inadequacy
and inferiority especially if parents/ teachers, rebuff,
ridicule, constantly scold or ignore the child’s efforts
to improve.
 Adolescence
 : Identity vs. Role Confusion
 Entering adolescence, children experience “
psychological revolution” search for answers to
the questions “ who am I”, what do I value”, “
where am I headed in life?; trying on many new
roles; and parent/teen conflict usually occurs.
resolution : establishment of an integrated and coherent
image of oneself as a unique person resulting to a
sense of centered identity.
Non – resolution : role confusion or negative identity like
“ hoodlum” or delinquent.
 Young Adulthood
 Intimacy vs. Isolation
Intimacy : the capacity to reach out and make
contact with other people; ability to share
with and care for another person without fear
of losing oneself in the process; ex. Deep
friendships and lasting relationships
Rejection : results to withdrawal, isolation and
formation of shallow relationships.
 Middle Adulthood
 : Generativity vs. Stagnation
Generativity – entails selflessness ; reaching out
beyond one’s own concerns to embrace the
welfare of society and future generations
through creative or productive work and
caring for children.
Stagnation – people are pre-occupied with their
material possessions or physical well being
( self – centered, embittered individual)
 Old Age
 Ego Integrity vs. Despair – towards
twilight years, people tend to take stock of
their lives or do a self accounting. May
result to sense of satisfaction with their
accomplishments or despair.
 Piaget’s Theory of Cognitive
Development
 Universal Constructivist Perspective – the child
constructs reality by interacting with the
environment and that children have predictable
qualitative differences in how they think about
things at different ages.
 All humans construct their understanding of the
world in predictable ways. Humans take an active
role in their own development by acting on the
physical environment.
 Key Concepts :
 Mental Structures – cognitive structures – begins with
reflexes in infancy evolving into schemata and more
complex structures called operations
 Schema – a mental concept formed through experiences
with objects and events
 Schemata – are building blocks of cognitive structures
 Operations – mental actions allowing children to interact
with the environment using their minds and bodies;
invariant sequence where child must first develop
concrete operations before formal operations.
 Organization – humans have natural and innate
tendency to organize their relationship with the
environment; people organize activity lawfully,
constructing a reality that makes sense at that time.
 Lawrence Kohlberg – Moral
Development Theory
 Three Levels and Six Stages of Moral Development
Pre – conventional Level
Stage 1 – Punishment / obedience orientation
 ego centered … self centered : “ survival of the fittest”
 obedience to figure of authority brought about by fear of
physical punishment
Stage II – instrumental – relativist orientation
 concerned with satisfying oneself at the expense of others
 or doing something for others based on what gain or
benefit he/she can derive for a favor done
 Conventional Level
Stage III – Good boy / nice girl orientation
 the child becomes other – directed and the
concern is for social approval and acceptance
 thus behavior conforms to accepted social and
traditional norms and practices
Stage IV. Law and order orientation
 decisions are based on the rule of the law, honor
and commitment duty
 Post – conventional Level
Stage V – social contract orientation
 depends on social contracts, written documents,
abstract thing and highly legalistic concerns
 believes in the saying, “ the law must be for the
greatest number of people”
Stage VI – Universal ethical principle orientation
 behaves according to concept of universal social
justice
 respect for human rights and upholding of the
principles of dignity, equality and justice.
 THE DETERMINANTS OF
LEARNING
Learning Needs – what the learner needs to
learn
Learning Readiness – when the learner is
receptive to learning
Learning Style – how the learner best
learns
 LEARNING NEEDS
Methods in Assessing Learning Needs:
 1. Informal conversations or interviews – asking open
ended questions
 2. Structured interviews – where the nurse may asks the
patient some predetermined questions to gather
information regarding learning needs; the answers may
reveal uncertainties, anxieties, fear, unexpected problems
and present knowledge base.
 3. Written pretest – can be given to identify the knowledge
level of the potential learner and to help in evaluating
whether learning has taken place by comparing the pre-
test and post-test scores.
 4. Observations of health behaviors over a period of
different times may help determine established patterns of
behaviors .
Steps in the Assessment of Learning
Needs:
 1. Identify the learner
 2. Choose the right setting – establish a trusting environment by
ensuring privacy and confidentiality especially if confidential
information will be shared.
 3. Collect data on the learner – by determining the characteristics
learning needs of the target population, patient or any recipient of the
learning material
 4. Include the learner as a source of information – allow the learner to
actively participate in identifying his needs and problems
 5. Include members of the healthcare team – collaborate with the other
healthcare professionals who may have insights or knowledge of the
patient or learner.
 6. Determine the availability of educational resources – use appropriate,
available, affordable, easy and simple to manipulate materials and
equipments
 7. Assess demands of the organization – examine the
organizational climate, its philosophy, vision, mission
and goals to know its educational focus.
 8. Consider time management issues – allow learners
to identify their learning needs ; identify potential
opportunities to assess the patient anytime, anywhere
and minimize distractions / interruptions during
planned assessment interviews.
 9. Prioritize needs – this may be based on Maslow’s
hierarchy of needs where the basic lower level
physiologic needs must first be met before one can
move up to the higher, more abstract level of needs.
 Criteria for Prioritizing Learning
Needs:
 a. Mandatory – learning needs that must
be immediately met since they are life
threatening or needed for survival.
 Ex. Patient with history of recent heart
attack should be taught the signs and
symptoms of an impending attack and
what emergency measures are or what
medicines to take.
b. Desirable – learning needs that must be met to promote
well being and are not life – dependent.
 Ex. Patient with pulmonary tuberculosis needs to
understand and appreciate the importance of taking her
medicines regularly until the regimen ends to be totally
cured.
c. Possible – “ nice to know” learning needs which are not
directly related to daily activities
 Ex. An obese patient who just lost weight because of her
diabetes may not necessarily need information on “
tummy tucking” as a surgical and aesthetic procedure to
remove the sagging abdominal muscles. Her current
mandatory learning needs are related to her illness.

 READINESS TO LEARN
In assessing readiness to learn, the health educator
must;
 1. determine what needs to be taught
 2. find out exactly when the learner is ready to
learn
 3. discover what the patient wants to learn
 4. identify what is required of the learner;
what needs to be learned
what the learning objectives should be
find out in which domain of learning and at what level the
lesson will be taught
 6. determine if the timing is right or proper
 7. find out if rapport or interpersonal
relationship with the learner has been
established
 8. determine if the learner is showing signs of
motivation
 9. assess if the plan for the teaching matches the
developmental level of the learner
 Four Types of Readiness to
 Learn
1. P= Physical Readiness
measures of ability – adequate strength, flexibility and
endurance is needed to be ready to learn
complexity of task – the difficulty level of the subject or
the task to be mastered.
Environmental effects – refers to an environment that
is conducive to learning, free from noise and other
distractions which may affect the physical readiness
to learn.
Health status – is the patient in a state of good health or
ill health? Does he still have the energy or
motivation to learn?
Gender – studies show that men are less inclined to seek
health consultation or intervention than women.
Women on the other hand, are more health
conscious and receptive to medical care and health
promotion teaching.
 2. E = Emotional Readiness
a. Anxiety level – a moderate level of anxiety
contributes to successful learning and is the
best time for learning, however too much
anxiety interferes with the learning ability.
 Fear greatly contributes to anxiety and
exerts negative effects on readiness to learn
whether it be in the cognitive, psychomotor
or affective domains of learning or even
lead a patient to deny his or her illness.
 b. Support system
a strong support system composed of the immediate
family and friends, significant others, the community
and church will give the patient increased sense of
security and well being, while a weak or absent
support system elicits sense of insecurity, despair,
frustration and a high level of anxiety.
 - nurses who provide emotional support to the
patient and family members go through what is
termed as “ reachable moments” which allow
opportunity for both nurse and client to
mutually share and discuss concerns and
possible solutions or alternatives to care.
 c. Motivation
 is strongly associated with emotional
readiness or willingness to learn.
 A telling cue is when the learner
starts asking questions and showing
interests in what the teacher is doing
or saying.
 d. Risk taking behavior
are activities that are undertaken without much
thought to what their negative consequences
or effects might be.
 the role of the health educator is to develop
awareness in the patient as to how this can shorten
his life span; how to develop strategies to minimize
the risk; to recognize the signs and symptoms of
probable disease state and what to do should this
worst case scenario develop.
 e. Frame of Mind
 depends on what the priorities of the
learner are in terms of his needs
which will determine his readiness to
learn. An important consideration is
Maslow’s hierarchy of needs as a
guide in identifying needs
prioritization.
 f. Developmental stage
 determines the peak time for
readiness to learn or “ teachable
moment “
 3. E = Experiential Readiness
 refers to the previous learning experiences
which may positively affect willingness to
learn.
a. Level of Aspiration – depends on the short
term or long term goals that the learner has set.
b. Past Coping Mechanism – refers to how the
learner was able to cope with or handle
previous problems or situations and how
effective were the strategies used.
c. Cultural Background
d. Locus of Control – refers to motivation to learn
which may internal or external locus of control.
e. Orientation – this refers to a person’s point –of- view
which may be
Parochial – close minded thinking, conservative in their
approach to new situations, less willing to learn new
materials and have great trust in the physician.
Cosmopolitan – more worldly perspectives and more
receptive to new or innovative ideas like current
trends.
 4. K = Knowledge Readiness
 It refers to :
Present Knowledge Base – also referred to as stock
knowledge, or how much one already knows about the
subject matter from previous and vicarious learning
Cognitive Ability – involves lower level of learning which
includes memorizing, recalling, or recognizing concepts
and ideas and the extent to which information is
processed indicates the level at which the learner is
capable of learning.
 PRINCIPLES OF LEARNING
( MOTIVATION)
 1. Use several senses
 When dealing with the question of how much
people are able to retain what has been learned,
it has been shown that people retain :
 10% of what they read
 20% of what they hear
 30% of what they see or watch
 50% of what they see and hear
 70% of what they say
 90% of what they say and do
 2. Active Learner Involvement

 To actively involve the patients or clients in

the learning process. Use more interactive
methods involving the participation of the
learners like role playing, buzz sessions, Q
& A format, case studies, small group
discussion, demonstration and return
demonstration.
3. Conducive Learning Environment
 Always consider the comfort and
convenience of the learner
4. Learning Readiness
5. Relevance of Information
 Anything that is perceived by the
learner to be important or useful will be
easier to learn and retain.
6. Repeat Information
 Continuous repetition of information over a period of
time enhances learning; applying the information to a
different situation and asking the learner to apply the
information to another situation or rewording it and
giving practical applications will help in the learning
process.
7. Generalize Information
 Cite applications of the information to a number of
applications. Give examples which will illustrate or
concretize the concept.
8. Make Learning a Pleasant Experience
 Give frequent encouragement, recognize
accomplishments and give positive feedback.
9. Be Systematic
 Begin with what is known; move towards the
unknown. A pleasant and encouraging
learning experience if information is presented
in an organized manner and with information
that the learner already knows or is familiar.
10. Be Steady
 Present information at an appropriate rate.
This refers to the pace in which information is
presented to the learner….are you talking too
fast or too slow about the topic you are
discussing?