Assessment of the learner involves the definition of the learners need, the readiness and the styles of learning. It is of paramount importance to carry out an assessment before commencement of the actual learning process so as to optimize learning for the patient. Failure to thoroughly asses the patient may have serious implications to the ability of the learner to care for self once out of the healthcare institution set up (Bastable, 2007). Three determinants of ability are identified; the learning needs and the readiness to learn and the learning style.
Learning needs are the gaps of knowledge that the educator has to fill to have effectively educated the learner (Stephens, 2008). The needs are determined by how much the patient is willing to learn and how much material need to be transferred to the learner during the process. The identification of the learning needs of the client is crucial for formulation of teaching plan unique to that person (Bastable, 2007).
Our client is a 27 years old lady known as Ms. Bettendorf who has been recently diagnosed with insulin dependent diabetes that requires significant change of lifestyle and institution of self care and medication protocols to cope with this condition and thus requires being educated thoroughly on how to do it.
She lives a relatively active life and the sudden occurrence of the diseases came as a shock to her; she has a passion for dancing and attends lesson for 2-3 times per week; she also regularly goes to the gym; thus she is relatively healthy except of the diabetes. She has no visible physical deformities or injuries.
The client first suspected that something was wrong with her when she started feeling constantly thirsty and hungry; tired and weak.
The client is currently complaining of tremors, sweating, palpitation, and tachycardia during her dancing sessions; apart from these she has no other outward signs of disease. The client is of sound mind and of rational thought and is able to understand her environment including her conditions and appreciates that she has a lot (and needs) to learn.
Setting for learning
It is very importance to choose the correct setting for optimal transfer of information to the client. The correct environment also allows the client to feel secure to share her intimate thought regarding her condition and where she can feel supported and cared for (Carlson, 2006).
We are going to hold the learning sessions in the family apartment; it is a spacious 5 bedroom home which she shares with her parents and her 17 year old sister who is in high school. The apartment is ideal since it is a familiar environment with the warm feeling of family. Additionally, it doesn’t have many distractions, for example small kids; and her parents are relatively advanced in age. The apartment is additionally located in a gated community.
Data regarding the client
The client’s mother is healthy and with no major health issues; the family however has a history of diabetes and hepatic cancer on the maternal side; and a long history of hypertension and testicular cancer on the paternal side. The client’s father is in fact under medication for hypertension. Apart from this the family has no other physical condition.
The history of diabetes is very close on the maternal side as the client remembers that her maternal grandmother had the condition and had to inject herself with insulin when she needed to; and that she had reduced sensation to her legs even that she couldn’t realize injuries on her feet.
The client’s family
The immediate family of the client comprises the parents and her younger sibling. Her mother is 60 years old and is a realtor and owns her insurance company; on the other hand, her father is the 61 years old electrical engineer. Her sister is 17 years old, is in high school and in the drill team. They all live together as a household in an apartment.
The extended family is active church goers; every Sunday the whole extended family attends church together. The family is very close knit and they all reside in Westville except for the father’s family that resides in the West coast.
The client also has a close-knit network of friends from her high school days; all these people are there to support the lady through her diabetes ordeal.
Members of the healthcare fraternity
The client is attended by a family physician who they completely trust; the relationship between the family and the clinician is close and the doctor is able to effectively address any issues that the client raises. The learning process may be formulated to take advantage of this relationship as the physician may be able to get through better to the client than a stranger. Additionally he will be able to monitor the competency of the client in taking good care of her-self.
Prioritization of needs
The client’s learning needs is prioritized into three categories; the mandatory, the desirable and the possible (Bastable, 2007); in descending importance.
These are the things she has to learn that are essential to her survival and which ignorance would be a threat to her life. She has to know how to measure her blood-sugar levels; and she has to know the implications of the different levels to her wellbeing. She has to know when to seek emergency medical attention if she cannot control her diabetes. She also has to learn how to administer insulin to herself.
These are issues that even though they may not be of immediate threat to her life, have an implication to her wellbeing (Bastable, 2007); for example, she has to learn how to take care of her feet to avoid injuries that may end up in amputation.
These are issues that are good to have knowledge of but are not essential to the day-to-day activities. For example, in case of future travel, the client may need to know the time zones of the destination and prepare accordingly (Bastable, 2007).
We will have to ascertain the availability of educational resources for the learning process of the client. These may include books and information pamphlets pertaining diabetes. Also, equipment to demonstrate how to measure blood-sugar levels and self-administration of insulin is needed. The family is however living on a stale financial base and acquisition of these resources will not be a problem.
The family is covered by health insurance that takes care of all their health costs. Additionally, the family is able to support self care that is going to become part of the client’s life. The client and the family are fluent in English; thus there are no language barriers to learning. The client’s family value education and are firm believers in western medicine. They do not prescribe to any folk medicine.
Time management issues
The client does not seem to have any major issues taking over her time; thus there is flexibility on formatting a learning schedule that will have minimum interruption and maximum learning. It is better to avoid disrupting her schedule of exercising, dancing or going to church with her family; as these are important aspects of her life and are essential in supporting her during the adaptation to her new status.
Readiness to Learn
This is the point where the client demonstrates willingness to acquire new information bout her status; and on how to stay healthy.
Physical; the client has no physical effects that inhibit her from learning; she is in fact very physically active. The client is also of sound mind and capable of rational thought. She is able to perform ADLs successfully. She has no functional, cognitive or sensory disabilities. In terms of gender, females have been shown to take fewer risks with their health than male and to adhere better to medical regimes.
Emotional; the client has a very close-knit and supportive family. Additionally, she frequents church to get spiritual support. The client also asserts that there is no low self esteem in the family; and that the relationship between the members is very close. She also has many close friends. She admits however, that she is very anxious about her health since the diagnosis; her major worry is loosing sensation to her legs and not being able to follow her dancing passion.
The lady is independent and willful; this may make it difficult for her family to help her in the future. She also admits that she is indecisive when making decisions about her health.
Experiential; the client has had past experience with diabetes since her grandmother had the condition. However, she has little in-depth knowledge about the condition all together. She has accepted that injecting insulin will be an integral part of the rest of her life; just as she saw her granny do it. The family also has some experience of dealing with chronic disease due to the history of hypertension (which her father has), testicular cancer and diabetes. The family has a good educational background that emphasizes the importance of education.
Knowledge; the client has very scanty knowledge about the condition. However, she has excellent cognitive abilities. She and her family have no history of learning disabilities.
From the above assessment, the Miss Bettendorf is in a very good position to effectively learn how to cope with her newly diagnosed condition. The only part left is for the educator, who plays an equally important part to the process [Carlson, 2006], to formulate a personalized methodology based on this assessment.
- Bastable Susan Bacorn (2007): Nurse as Educator: Principles of Teaching and Learning for Nursing Practice Edition: 3, illustrated Published by Jones & Bartlett Publishers, 2007 Pp 95- 118
- Carlson ML, Ivnik MA, Dierkhising RA, O’Byrne MM, Vickers KS (2006): Learning needs assessment of patients with COPD. Medsurg Nursing. 2006; 15(4):204-12.
- Stephens PA, Osowski M, Fidale MS, Spagnoli C (2008): Identifying the educational needs and concerns of newly diagnosed patients with breast cancer after surgery. Clin J Oncol Nurs. 2008; 12(2):253-8.