THE LEARNER

- Motivation and Behavior Change

- Multicultural Aspects of Learning

Group 4
Salvacion, Janine A.
Soriano, Darlene Jane
Romasanta, Jerlyn
Costelo, Kurstin
Carreon,
Caigan
Rose
alfonso
 Motivation and Behavioral Change

Teaching is a part of nursing practice. For the education to be effective, the nurse must
not only be knowledgeable about the subject matter being taught, but also the
teaching/learning process.

Learning is a multifactorial activity that is often taken for granted, since we all learn all
the time. However, in a medical situation, there are many variables that play into the client’s
ability to learn that must be taken into account.

Teaching client new information and having him/her use it are two different thing. An effective
health education intervention encompasses more than just the giving of new information, for
information alone does not always result in behavior change, compliance or improved health
status.

Successful educational intervention increase compliance and they are based on learner
characteristics, his/her educational needs, theory and a sound educational plan.

Learner Characteristics

Culture

Culture is defined as invisible patterns that form the normal ways of acting, feeling,
judging, perceiving and organizing the world. All of the people function from a common set of
acceptable behaviors.

Culture affects health behaviors and the teaching/learning process in many ways. It
influences gender roles, sexual behaviors, diet, personal hygiene, body image, drug use,
exercise and communication among others.

Literacy
 The client’s ability to read and understand what is being read is an essential component
of learning. Establishing the reading level and using materials that is consistent with the client’s
ability is paramount.

Material at too high a level will be useless, as they will not be understood. Materials at
too low level may be too simplistic and may even be seen as insulting.

Illiteracy is often embarrassing and is not readily disclosed.

Age

As more of our population lives longer, it is increasingly the aged who are our clients.

 As with all the clients, emotional or mental status should be acknowledge.

 Older adults enjoy learning in a group.
 Be cognizant of possible hearing and visual deficits.

Education Level and Health Status

It has been documented that educational level is significantly associated with health
status.

Socio-Economic Level

The impact of socioeconomic level on learning has more to do with being able to use
the information being taught rather than the process of learning.
Planning for Learning

Learning Principles

1. Use several senses.

2. Actively involve the patients or clients in the learning process.
3. Provide an environment conducive to learning.
4. Assess the extent to which the learner is ready to learn.
5. Determine the perceived relevance of the information.
6. Repeat information.
7. Generalize information.
8. Make learning a pleasant experience.
9. Begin with what is known; move toward what is unknown.
10. Present information at an appropriate rate.

Motivation and Behavior Change Theories

Essential Components of Motivation and Behavior Change Theories

Theory Components

 Health Belief Model  based on perceptions or severity of

the health problems

 personal belief of susceptibility to

or risk of the illness

 benefits of adopting the new

behavior or changing the old
behavior
  change is triggered by cues to
action and supported or hindered
by modifying variables

 Perceptions are the individual’s

belief.

 Perceived susceptibility is the

belief of personal risk or threat of a
particular health problem.

 Transtheoretical or Stages of Change  Is useful when the targeted behavior

Model change is the discontinuation of an
unhealthy behavior. (smoking
cessation and weight management
intervention)

 Five stages people go through in the

process of change:

1. Precontemplation – before
they even begin to think about
the change.
Contemplation – when they
weigh the pros and cons of
changing the behavior.
2. Preparation – when they
 decide on how they will
undertake the change, what
they will do
3. Action – when they start the
change, they put the plan into
motion.
4. Maintenance – keeping the
new behavior and resisting the
old.
5. Termination – when the
behavior becomes a habit.

 Theory of Reasoned Action  This is based on a person’s intention to

do something.

 Intention to change behaviors is the

result of:
- A person’s attitude toward the
behavior – whether it is positive or
negative.
- Subjective norms – significant others
reaction to the behavior.
- Behavioral control – how easy or
difficult the person believes the new
behavior is.
 Social Cognitive Theory  Social Learning Theory

 Behavior is the result of an interaction

among the person, environment, and
the behavior itself.

 Based on reciprocal determinism.

 If one is changed, all are changed

 Self-Efficacy Theory  This is based on the idea that people

will do only what they think they can
do.

 Four variables that determine the

strength of a person’s belief in ability:
1. Performance accomplishment refers
to learning that occurs through
personal mastery of a particular skill
or task.
2. Vicarious experience learning
through observations
3. Verbal persuasion involves acting as
a coach and providing
encouragement.
4. Physiological state
  The most important determinant of
behavior change is learning a new
behavior by doing it.

 Behavior Modification Theory  Proposed by B.F Skinner

 Based on the premise that behavior

occurs because of its consequences.

 Changing the consequences,

reinforcements or rewards, then, can
change the behavior.

 Reward – if the person does what is

wanted, then the person is given
something pleasant.

 Punishment - if the person does not do

what is wanted, then, something
unpleasant is given.

Multicultural Aspects of Learning

Nurse educators in clinical settings recognize the importance of culture in

interacting with clients and colleagues. Eliason and Raheim contend that in dealing with
culture, there are two major roles for nurse educators:
1. Creating specific multicultural curricular content.
 2. Providing a learning environment for learners from all backgrounds.

Characteristics of Culture

 Race
 Gender
 Ethnicity
 Sexuality
 Identity
 Age
 Physical ability

Learning about Culture

1) Culture is learned and transmitted from one generation to another.

2) Culture is localized and is created through specific interactions with specific
individuals.
3) Culture is patterned.
4) Culture is evaluative.
5) Culture has continuity, with change.

Promoting Cultural Knowledge

Three main approaches to promote cultural knowledge and competency for

health care providers and nurse educators.

 First is the Fact-Centered Approach

 Second approach to Culture is attitude Centered
  Third method is an ethnographic approach to cultural competence

A Cultural Competence Model

Cultural competence is the ability to work efficiently in a cross-cultural situation.

Campinha-Bacote(1998)- defines cultural competence in the delivery of health care

services as the process in which the healthcare provider continuously strives to achieve the
ability to effectively work within the cultural context of a client , individual, family or
community.

Aspects of Cultural Competence

 Cultural awareness  Becoming respectful and
appreciative of another’s
culture.
- Is the process whereby the nurse
becomes respectful, appreciative
and sensitive to the values, beliefs ,
practices and problem-solving
strategies of a client’s culture.
- viewed from ethnocentrism to
ethnorelativism.
 Ethnocentrism – is a behavior in
which a person is totally unaware
to others cultural beliefs and
values.
 Ethnorelativism – reflects an
 attitude of nurses who value
respect and integrate cultural
differences into their practices.

 Cultural knowledge  Obtaining factual knowledge

about different cultures
Campinha-Bacote describes four stages.
 Unconscious Incompetence- is
identified as an individual’s being
unaware that he or she lacks
cultural knowledge.
 Conscious Incompetence- is the
awareness that he or she lacks
knowledge about another culture
and is willing to seek and obtain
the knowledge.
 Conscious Competence- is the act
of learning about a client’s culture
verifying generalization and
providing culturally responsive
nursing interventions.
 Unconscious Competence-is the
ability to automatically apply
knowledge and culturally
congruent care to client’s from
diverse cultural backgrounds.

 Cultural encounters  Is the process whereby a nurse

engages directly in cross-
cultural interactions with clients
 from culturally diverse
backgrounds.

 Cultural skills  Is the ability to collect relevant

data about a client’s health
history and health problems, as
well as to accurately perform
culturally specific physical
assessments.

 Cultural desire  Is the nurse motivation to

engage in the process of
cultural competence Nurses
need to want to work toward
competence as they provide
individualized and safe care to
clients.

The Culture of Teachers and Learners

There are specific characteristics of effective teachers related to working with

multicultural students. Many nurse educators are from the dominant culture and have never
examined their own culture. They may respond to different values and behaviors exhibited by
multicultural students with confusion, uncertainty, and possibly bias.

 Culture for teachers who work with multicultural students should consider the following:
  Become self-aware of your own cultural values, norms, and beliefs and the influence
they have on your view of life, family, and relationships.
 Develop and maintain an attitude of respect for the broad range of cultural differences
and their importance to individuals.
 Develop strategy for continuing education about predominant cultures in a given
community or institution.
 Explore the possibility of integrating the appropriate use of teaching strategies and
communications.
 Consider the use of other professionals and members of the community from other
cultures to learn more about the culture.

 Learners may vary according to six factors:

 Communication
- It is the means by which culture is transmitted and preserved through the generations.
Cultural patterns consisting of verbal and nonverbal expression of each cultural group
affect the way the group expresses ideas and feelings, the way they make decisions and
the way they communicate.

 Space
- An individual level of comfort is related to personal space or distance, and discomfort is
experienced when one’s personal space is invaded. Personal space is an individual
matter and varies with the situation.

 Social Organization
- Cultural behavior, or how one acts in certain situations, is socially acquired and learned.
These patterns of cultural behavior are important to the teacher because they provide
explanations for people’s behavior.

 Time
- It includes the ordering of the past, present, and future in terms of behavior and
outlook. In education, getting assignments done in a specific time frame is more
important for a learner who is present and future oriented.

 Environmental Control
- It refers to a person’s ability to plan activities that control nature. It also refers to the
person’s perception of his or her ability to direct factors in the environment.

 Biological Variations
- Educators should know that learners from different backgrounds have genetic biological
differences that may affect their classroom performance.