Assuring Meaningful Learning Using Evidence based Strategies Cary - PDF document

Training Adult Learners: Training Techniques Assuring Meaningful Learning Using Evidence ‐ based Strategies Cary Kreutzer, EdD, MPH, RD July 10, 2014 1 Objectives Learning – Assessment – Delivery - Evaluation – Organization • Understand & connect neuroscience and learning • Apply the Model of Information Processing and define strategies using the model to promote learning Create lesson plans ‐ define, organize and structure • • Create learning objectives using the Taxonomy for Learning, Teaching and Assessing (Anderson, LW & Krathwohl, D.R., 2001) • Understand & apply evaluation tools to assess audience training needs, solicit feedback on instruction & delivery, prepare for future education 2 1

Training Adult Learners: Training Techniques Patient & Group Education 3 Impetus: The Joint Commission • Standard PC.02.01.21: The hospital effectively communicates with patients (care, tx, sevice). – Hospital identifies pt. oral and written communication needs – Hospital communicates in care, tx. & svcs. That meets the pts. Oral and written communication needs.  Standard RI.01.01.03: The hospital respects patient’s rights to receive info in a manner he/she understands. The Joint Commission. (2010). The Joint Commission: New and Revised Standards and EPs for Patient ‐ Centered Communication, Accreditation Program: Hospital, Pre ‐ publication Version. The Joint Commission, Oakbrook Terrace, IL. 2

Training Adult Learners: Training Techniques Impetus: Healthy People 2020 Health Communication & Health Information Technology Objectives • HC/HIT 1. Improve the health literacy of the population. • HC/HIT 2. Increase proportion who report providers have satisfactory communication skills. • HC/HIT 3. Increase proportion of people who report providers always include them in decision making. • HC/HIT 13. Increase social marketing in health promotion programs (health depts., schools of public health) Impetus: Health Literacy • Health literacy, the essential backbone of informed patient engagement (Howard Koh, MD, MPH, Assistant Secretary for Health at the Department of Health and Human Services, Feb 2013). • ~ 12 percent of Americans have the skills necessary to navigate the health care system, leaving the majority of Americans at ‐ risk for unnecessary hospital admissions and readmissions, medication errors, and failure to manage their health conditions effectively. • Health care providers often assume that patients understand what they are told unless they indicate otherwise. Program for International Assessment of Adult Competencies (PIAAC), Literacy, Numeracy, Problem Solving, nces.ed.gov. 6 3

Training Adult Learners: Training Techniques American Medical Association Research & Video Series – Health Literacy • Language • Reading • Numeracy In 1998, the American Medical Association (AMA) became the first national medical organization to adopt policy recognizing that limited patient literacy affects medical diagnosis and treatment. American Medical Association’s Video on “Low Health Literacy: You Can’t Tell by Looking” http://www.youtube.com/watch?v=cGtTZ_vxjyA Impetus: Nutrition Care Process (Academy of Nutrition & Dietetics, 2003) Essentials of the Nutrition Care Process include the following: • Step 1: nutrition assessment to determine nutrient adequacy, health function, and behavioral status • Step 2: nutrition diagnosis to determine the etiology, cause, and contributing risk factors • Step 3: nutrition intervention to implement the evidence ‐ based action or medical nutrition therapy appropriate to the condition • Step 4: nutrition monitoring and evaluation to review and measure ongoing progress related to the established goals of intervention 8 4

Training Adult Learners: Training Techniques IDNT Reference Manual NCP Step 3: Nutrition Intervention • Food and/or Nutrient Delivery • Nutrition Education • Nutrition Counseling • Coordination of Nutrition Care 9 Nutrition Education • Content (E ‐ 1) – Instruction or training intended to lead to nutrition ‐ related knowledge. • Application (E ‐ 2) – Instruction or training intended to lead to nutrition ‐ related result interpretation or skills. 10 5

Training Adult Learners: Training Techniques Define Nutrition Education vs. Counseling • Information dissemination (Educ) • Active vs. passive (Educ) • Learner gains knowledge and skills & education is effective if learner integrates new knowledge into everyday life (Educ) • Counseling encompasses behavior and motivation, self ‐ efficacy, readiness to change 11 Learning Influences Person Environment Behavior 12 6

Training Adult Learners: Training Techniques Why are learning styles so popular? • What is your opinion about learning styles – Visual – Auditory – Kinesthetic • Pashler (2008) “We conclude therefore, that at present, there is no adequate evidence base to justify incorporating learning styles assessments into general educational practice” 13 Index of Learning Style Questionnaire For each of the 44 questions below select either "a" or "b" to indicate your answer. Please choose only one answer for each question. If both "a" and "b" seem to apply to you, choose the one that applies more frequently. 1.I understand something better after I (a) try it out. (b) think it through. 2.I would rather be considered • Visual (a) realistic. (b) innovative. • Auditory 3.When I think about what I did yesterday, I am most likely to get • kinesthetic (a) a picture. (b) words. 4.I tend to (a) understand details of a subject but may be fuzzy about its overall structure. (b) understand the overall structure but may be fuzzy about details. 5.When I am learning something new, it helps me to (a) talk about it. (b) think about it. 14 7

Training Adult Learners: Training Techniques Your experience as a learner • Think back to college or high school – What teaching strategies did the instructor offer that supported OR did not support your learning – What learning strategies did you utilize that supported OR did not support your learning 15 Model of Information Processing: How knowledge is stored in Long Term Memory Elaboration Rehearsal Organization Visual Input Storage Short-term Long-term Sensory Working Memory Store Memory Retrieval Auditory Input Attention Memory Memory Loss Loss 8

Training Adult Learners: Training Techniques Learning Capacity and Duration Short ‐ term Working Long ‐ term Sensory Store Memory Memory Capacity Large Small Large Duration Very Short: 5 ‐ 20 Indefinitely seconds long Visual=1 second or less Auditory=2 ‐ 3 seconds Making Information Meaningful Making Information Meaningful Activity Organization Elaboration • Put learner in the most • I mpose order and • Expand on existing active role possible in connections in new schemas – Scaffolding - making connections and information Zones of proximal information meaningful development (Vygotsky, 1978) 9

Training Adult Learners: Training Techniques Kurt Fisher, PhD, Professor, Harvard School of Education • http://www.learner.org/courses/neuroscience • Unit 5 Dynamic Skill Development • Neuroscience in the Classroom • Dynamic Skill Scale Levels of learning – action, representation, abstraction Sensory + motor = representation Additional videos and curriculum can be used for training – funded by Annenberg Foundation 19 Understanding the importance of prior knowledge ‐ Schemas Read the following passage and see how much you remember afterwards. 10

Training Adult Learners: Training Techniques The procedure is actually quite simple. First you arrange things into different groups depending on their makeup. Of course, one pile may be sufficient, depending on how much there is to do. If you have to go somewhere else due to lack of facilities that is the next step, otherwise you are pretty well set. It is important not to overdo any particularly endeavor. That is, it is better to do too few things at once than too many. In the short run this may not seem important, but complications from doing too many can easily arise. A mistake can be expensive as well. The manipulation of the appropriate mechanisms should be self-explanatory, and we need not dwell on it here. At first the whole procedure will seem complicated. Soon, however, it will become just another facet of life. It is difficult to foresee any end to the necessity for this task in the immediate future, but then one can never tell. Rote vs. meaningful learning • Simple repetition • Recognizing • Keeps info in WM, similarities but does not necessarily • Constructing transfer to LTM personal meaning • Passive learning • Encoding in LTM • Active learning 11

Training Adult Learners: Training Techniques Instructional Techniques for Selecting ‐ to decrease cognitive load • Selecting = helping the learner pay attention to the relevant information • Objectives • Pre ‐ questions • Post ‐ questions • Highlighting Instructional Techniques for Organizing ‐ to move information to long term memory • Organizing = helping the learner build an organized structure (also called scaffolding) – Outline – Headings – Pointer words – Graphic organizer 12