Posted: July 14th, 2022

Teaching and Learning Project NUR 112

MONTGOMERY COUNTY COMMUNITY COLLEGE
NUR 112 Teaching-Learning Project
At the completion of this teaching-learning project the student should be able to:
1. Demonstrate the principles of the teaching-learning process.
2. Identify learning needs and formulate a teaching plan for the client with a knowledge
deficit.
3. Select teaching methodologies to reflect developmental, cultural and other relevant client
factors that influence the teaching/learning process.
4. Identify appropriate therapeutic communication techniques to use during client teaching.
5. Utilize appropriate resources to support the teaching-learning process.
6. Illustrate correct use of APA format.
PREPARATION
• Faculty will be available during the first two weeks of the semester to Help student in
developing preliminary teaching scenario and measurable learning objectives.
• SUGGESTED REFERENCE FOR REVIEW OF COMMUNICATION TECHNIQUES:
Taylor, Lynn, & Bartlett (2019). Fundamentals of nursing. (9th ed.) Chapter 8
• SUGGESTED REFERENCE FOR REVIEW OF TEACHING/LEARNING PROCESS:
Taylor, Lynn, & Bartlett (2019). Fundamentals of nursing. (9th ed.) Chapter 9
ACTIVITY
Students will develop a 15-minute teaching-learning session between a nurse and a client.
Students may base this project on an actual or fictitious interaction with a client. The client may
be any age through the lifespan.
Suggested topics are to be within the concepts of Safety/Protection from Infection, Activity/Rest
& Sleep, Regulation/Sensation, and Oxygenation to Help in your preparation for coinciding unit
tests #1 and #2.
The student will submit a typed project using proper APA format for title page, abstract,
references and citations, and should be no more than 7-8 pages. The abstract is to be
developed describing the teaching scenario and factors related to the client that would affect the
teaching-learning process. A teaching outline based on a “deficient knowledge [learning need]”
or “readiness for enhanced knowledge” nursing diagnosis should follow the abstract (see
sample teaching outline below). Within the intervention section of the teaching outline identify
the specific content areas you plan to address to meet your patients learning goals, along with
the communication techniques and teaching methods you intend to utilize in the presentation of
these content areas. Be sure to include the rationales for the teaching methods selected for the
identified content area(s). The reference pages conclude the typed project and should include
annotated bibliographies of the resources used to prepare the teaching plan.
Appropriate patient resources (i.e. printed materials) that would be given to the client during the
teaching session are expected to be developed or identified and copies submitted with the typed
project.
FOLLOW-UP ACTIVITIES
1. There must be a minimum of 3 references which may include textbooks, professional
nursing journals, internet resources, or appropriate health care organization materials
identified as evidence-based research of content. (Be sure all hyperlinks are active
within citations and reference page for validation of appropriate electronic sources.)
2. Obtain/download copies of selected patient teaching resources (i.e. printed handouts)
that you plan to incorporate into your teaching plan.
3. The completed typed project is due on the date of T/L Presentations indicated on the
course calendar. (All materials are to be uploaded to the T/L Assignment space on Bb.)
STUDENT Assessment
Grading (10% of final course grade)
Teaching Plan (0-10) grade by faculty
(0-2) Teaching/Learning Process: Developed an “actual” nursing diagnosis
identifying the client’s learning need(s) with appropriate “SMART” client
learning goals, planned interventions, and Assessments of client learning.
(0-2) Content Outline: Developed a written teaching plan with specific content
areas addressing the identified client learning needs and goals. Integrated
evidence-based research to support specific content to be taught.
(0-2) Communication Techniques: Identified a variety of therapeutic
communication techniques within teaching plan that consider the client’s
culture, literacy and developmental levels. Provided rationale for chosen
communication techniques.
(0-3) Teaching Methods: Identified specific strategies appropriate to effectively
teach concepts in plan and achieve identified client learning goals. Utilized a
variety of methodologies with consideration of client age, literacy level and
developmental levels. Provided rationale for chosen strategy/method.
Included links and copies of selected patient-teaching materials/handouts to
be utilized.
(0-1) Correct use of APA for title page, abstract, citation of patient resource
materials within the teaching outline, and writing of reference page with
annotations.
SAMPLE:
ABSTRACT (Remember this is on its own page, as page 2 of your project. Follow APA
guidelines.)
A client presents to a health care provider. The client is a healthy, single 42-year-old female with
a BMI-28.3, and a family history of breast cancer. Her mother developed breast cancer at age
52, and her grandmother developed breast cancer at some point after turning 40 years old;
family members cannot recall precisely when. The client states she does not perform self-breast
exam, and she has not seen a gynecologist since the birth of her daughter, which was 22 years
ago. She is asking if she should schedule screening mammogram, and curious about breast
health awareness. The following teaching outline represents a detailed plan to address the
client’s learning needs.
TEACHING OUTLINE (This begins on page 3.)
I. NURSING DIAGNOSIS
Deficient knowledge: Breast health awareness related to lack of information as evidence by
client’s statement: “…should I schedule screening mammogram, and I am curious about breast
health awareness”.
II. CLIENT GOALS/LEARNING OBJECTIVES
A. Short term goals. At the completion of this teaching session, the client will:
1. Explain the purpose of breast health awareness
2. Identify her specific breast cancer risk factors
3. Demonstrate the correct procedure for breast self-exam (BSE)
4. Discuss the mammography procedure for breast cancer detection
5. Verbalize importance of annual breast surveillance
B. Long term goals. By follow up with nurse client will:
1. Record practicing monthly BSE
2. Schedule an appointment for a bilateral screening mammogram
III. INTERVENTIONS (NOTE: Content within table can be single-spaced.)
Content Communication Technique/Teaching
Method with Rationale
Client’s perception of Breast Health
Awareness (BHA)
Question/answer and open discussion to
establish baseline level of the client’s
understanding of BHA.
Open-ended relevant question: Can you tell
me what you understand about breast health
awareness (BHA)?
Creation of a supportive atmosphere with
professional attitude and communication style
– both verbal and non-verbal promotes open
discussion.
Review aspects of breast health awareness
using evidenced –based information in a slow
methodical fashion
Use open discussion and use of printed
learning materials such as________
(citation) to describe risk factors and warning
signs of breast cancer.
Discussion and written material can help
identify any literacy issues; printed pamphlets
can reinforce content being taught, as well as
serve as a resource when the client returns
home, as long as the client can understand
them.
Use return verbalization to evaluate the
client’s comprehension of complex health
related material. Ask the client to review the
information about BHA.
Risk factors for Breast Cancer – Review of
client/family health history
Sharing observation: I noticed in your
health history that you have 2 female family
members who have had breast cancer. Can
you tell me anything more about that?
Questions such as these can initiate
conversation and allow the client to confirm
or deny the observation.
Summarization: summarize the client’s
specific risk factors for breast cancer after a
thorough discussion and ask her to review
them.
Use summarization and return verbalization
to evaluate the client’s comprehension, and
her recall of significant risk factors.
Discuss the use of Breast Self- Exam (BSE)
in breast cancer detection.
Have the client refer to illustrations and then
allow her to touch the breast cancer demo models.
Visual and Kinesthetic learning sources
(with citations) requires examining a picture,
chart, CD, DVD, TV program etc. and can be
reinforced by tactile learning on a breast
cancer-demo model which allows the client to
absorb content in stages, using a variety of
senses.
Demonstrate the correct procedure for BSE.
Stress that the procedure be done each
month 7-10 days after the onset of
menstruation or at the same time each month
for those that are not menstruating.
Demonstration & return demonstration on
a breast model may be helpful. The nurse
needs to be very supportive and give a lot of
positive feedback as some women may be
embarrassed. The nurse needs to
demonstrate an accepting attitude.
Record keeping of monthly BSE. Journaling is an objective way to evaluate
patient progress. Give sample calendar to
check off monthly exams.
Discuss mammography procedure, why it is
recommended, how it is done and how it will
feel. Discuss benefits, risks, and cost.
Question/answer to assess client’s
understanding of importance of screening
mammography.
Use of printed learning materials such
as________ (citation) to describe the
mammography procedure.
Open discussion is useful to identify the
client’s questions and concerns. Creation of a
supportive atmosphere with professional
attitude and communication style – both
verbal and non-verbal promotes open
discussion
Follow-up Plan Summarization: summarize the agreed upon
plan for breast cancer detection and follow
up.
Gives the client an opportunity to get
clarification and to indicate if aspects of the
plan are not preferable or achievable.
IV. Assessment OF CLIENT
A. STG: Goals met. Client’s verbalization indicated her understanding of value of BHA, risk
factors, and BSE and mammography as detection methods of breast cancer. Client
demonstrated correct procedure for BSE on model.
B. LTG: Goals met. Client set up a schedule for monthly BSE—first Tuesday of the month
(usually 1 week after menses); and scheduled mammogram for 4 weeks to coincide with
follow-up exam.
REFERENCES (All references utilized will be listed with their associated annotations on the
“Reference” page following appropriate APA reference format.)
The identified references will consist of two elements:
1. Citation of source in current APA style format
2. Annotation – the annotation should have several sentences summarizing the main points
or ideas found in the source (descriptive). It should also include your own statement
evaluating the quality of the source and why it was helpful to your project’s topic
(evaluative).
Useful sites regarding correct APA citation formats and how to write an APA annotated
bibliography:
• MC3 Library Help Zone for APA format –
https://library.mc3.edu/friendly.php?b=g&d=a&group_id=6204
• APA General Guidelines (Purdue University OWL) –
https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_g
uide/apa_sample_paper.html
• OWL Resource Link – Annotated Bibliography Samples –
https://owl.purdue.edu/owl/general_writing/common_writing_assignments/annotated_bibl
iographies/annotated_bibliography_samples.html
• UMUC APA Annotated Bibliography Guidelines –
https://sites.umgc.edu/library/libhow/bibliography_apa.cfm
Student Grade Sheet for Teaching/Learning Project
Title of Project: ______________________________________________________
Student Name________________________________________________________
Assessment Area Comments Points
Teaching Plan
Demonstration of
Teaching/Learning
Process (0-2 points)
(Developed an “actual”
nursing diagnosis identifying
the client’s learning need(s)
with appropriate “SMART”
client learning goals, teaching
plan, and Assessments of client
learning.)
Content (0-2 points)
(Developed a written teaching
plan with specific content
areas addressing the
identified client learning
needs & goals. Integrated
evidence-based research to
support specific content to be
taught.)
Communication
Techniques (0-2 points)
(Identified a variety of
therapeutic communication
techniques within teaching
plan that considered the
client’s culture, literacy and
developmental levels.)
Teaching Methods
(0-3 points)
(Identified specific strategies
appropriate to effectively
teach concepts and achieve
identified client learning
goals. Utilized a variety of
methodologies with
consideration of client age,
literacy level and
developmental levels.
Included copies of selected
patient teaching materials.)
Assessment Area Comments Points
APA Writing Style
(0-1 point)
(Correct use of APA for title
page, abstract, citation of
patient resource materials
within the teaching outline,
and writing of annotated
bibliography within
designated reference page.)
Total Points
Final Grade _______________
Faculty signature __________________________________

—-

Teaching and Learning Project
Sandrin Francis
Institution

Teaching and Learning Project
Abstract
A client presents to a healthcare provider. The client is 31 year old male. He has been newly diagnosed diabetic. Client has a BMI of 31.1 up from 34.8 last year. The client has a family history of diabetes but on the Dad’s side. His father developed diabetes mellitus in his late 60s and had been battling the diseases, as well as arthritis with chronic lower abdomen pain. The grandmother on his father’s side developed diabetes earlier on in life at 32 years of age, and had successfully coped with the disease well into her old age. She was also diagnosed with cataract but an early diagnosis and subsequent surgery successfully got rid of the cataract. The client states that he has started taking physical exercises (he regularly runs, dances and swims), record and manage regular carb intake, the client has also increased fiber intake, and drinks upto 4 liters of water a day. Up to his diagnosis, which was almost one and a half year ago, the client did not use to monitor and control his blood sugar levels, but this is something he does regularly now. The client also chooses foods with low glycemic index which was recommended to help reduce blood sugar levels. Client has limited knowledge and awareness on how to survive with the disease and the complex nature of the disease in a social context, majorly because he is single and working with no family member close, as such client seeks to establish a reliable and valid measures for self management of diabetes to ensure a good outcome. The following report outlines a detailed plan that should supplement already established regime to help client properly self administer the insulin medication in an appropriate manner.

I. NURSING DIAGNOSIS
Deficient knowledge: limited knowledge on insulin treatment is required as the client struggles with the thought of insulin being dangerous to their health and showing that they have poor lifestyle choices most of which he has heard from others. This is evident through the client’s statement that…Insulin consumption to regulate blood sugar levels means he is a “failure” or the fact that he can take “breaks or …holidays” from insulin consumption from time to time, or that insulin has made him gain considerable weight that he had already lost and that it becomes addictive and predisposes him to death. Client wants to understand further the effects of insulin and whether it will continue being “painful” to take insulin for most of his life.
Client understands that diabetes mellitus (DM Type 2) is progressive chronic metabolic disorder perpetuated due to deficiency of insulin hormone. This is evident by the fact that he already verbally asserted that he understood that he will be exposed to the insulin shots most of his life. Client understand that diabetic patients are limited to adequate and constant glycemic control. Glycemic levels must be kept under control for a continued amount of time and without holidays. Failure to maintain euglycemia results in overmedication among other physiological factors.
Research indicates that diabetic patients especially those under insulin medication are at a higher risk of developing hypoglycemia (deficiency of glucose in the blood stream), while treatment with oral agents such as sulfonylureas greatly increases the risk of hypoglycemia further (RamBihariLal Shrivastava, Shrivastava, and Ramasamy, 2013). Client needs to understand the asymptomatic episodes that constitute manifestation of hypoglycemia constitutes upto 10% of a 24 hour period in diabetic patients, it also increases the risk of upto 16 symptomatic episodes annually, and one episode over a 5 year term (Perlmuter, et al., 2008). The risk for more episodes increases with more treatment with insulin. Overall, there is need to emphasis to the client that self-care, through adequate self-administration of the insulin medication is an evolutionary process of development that comes along with better self-care behaviors centered on lifestyle improvement.
II. CLIENT GOALS/ LEARNING OBJECTIVE
A. Short Term Goals (STGs) At the completion of this teaching client will be able to:
1. Explain the purpose of insulin administration
2. Identify the specific type of diabetes and the potential symptoms that follow the diabetes mellitus type 2
3. Identify and becomes aware of hypoglycemia and how it manifests
4. Identify what constitutes symptomatic and asymptomatic episodes that accompany hypoglycemia
5. Define the correct glucose levels and the complications that come with different levels
6. Understand and clearly verbalize impotence of insulin therapy
7. Be able to assess, create a schedule and adhere to insulin self administration- establish an adequate and very helpful delivery system design i.e understand that he is moving from a reactive to a proactive care delivery system.
8. Understand why it is important to change to enact a behavior change and sustain a healthy behavior change lifestyle
B. Long Term Goals (LTGs): By follow up with the nurse, client will have:
1. Recorded their blood sugar levels and schedule delivery system
2. Created a home-based self-management support system
3. Decision support system that will adequately provide alternative decision in times when client cannot
4. optimized provider and support team behavior
5. Created adequate avenues that support patient behavior change in the long run
6. Change the care system to be primarily home-based
7. Established an accurate follow-up plan for the treatment that changes and assesses progress and the targets of treatment
III. INTERVENTIONS
Content Communication Technique/ Teaching Method with Rationale
Client’s perception of Insulin treatment in Type 2 DM This will be approached through question and answer in order to establish the clients perspective on insulin therapy as well as the his social value system.
Open ended question: what do you know about insulin? What have you had about insulin therapy?
This will be in order to create an open and supportive environment where they do not feel judged. Marcus (2014) identify that verbacity creates an inclusive and a more trusting environment for the client.
Reviewing myths of insulin using evidence-based information using demonstrations and verbal explanations This will be done mainly also through verbal inquiry and addressed using visual aids and demonstrations centered on educating the client. It will focus ion reviewing evidence based research and findings as well as instituting teach-backs. The goal of the teach back wil be to ensure that the patient has conceptualized the information and can be able to communicate the importance of the therapy back to me in their own word.
What have you understood about insulin therapy and diabetes in general?
Risk factors associated with lack of treatment of DM Type 2 with insulin Visual aids and tools will be utilized to supplement verbal and physical demonstration as well as reading materials from trusted sources. Patients will have the opportunity to ask as many questions and they will be provided with verbal expectations resulting from the treatment. Can you verbalize the process involved in self management?
Side Effects associated with lack of treatment of DM Type 2 with insulin Visual aids and tools will be utilized to supplement verbal and physical demonstration as well as reading materials from trusted sources. What are some of the side effects you have experienced so far?
Importance of insulin in the treatment of DM Type 2 Sharing observation from the client’s perspective
Summarization of various importance and myths associated with insulin therapy
Demonstrate the correct procedure for self-administration of insulin injections/ shorts Nurse will provide a demonstration the correct procedure for insulin administration. Teach back: Client will be encouraged to teach it back to the nurse
Audio and visual tools will be forwarded to the client for easier reference
Return demonstration will be required to ensure that client understand self administration.
Importance of daily record keeping for follow up plan Journaling: Creating a timed schedule and journal experiences and reactions and feelings
Open Discussion that provides a summary of the experiences and the delivery design system. Provide me with a comprehensive list and programs involved, or any changes experienced?

IV. Assessment OF CLIENT
A. STG: Goals Met. Client’s verbal understanding of the insulin therapy and the process of self administration. Teach back should be employed during verbalization, client should also establish a positive attitude of the process to ensure they do not relapse. Research identifies that social pressures and clients lack of education and perception on the importance of insulin therapy play a great role in leading most clients to stop medication (American Diabetes Association, 2016). Gerada et al., (2017) point out that non adherence to insulin self administration was contributed greatly by forgetting time to perform injection and deliberately feeling better or worse due to social pressures that inform experiences that people had. They should understand that halting medication is heavily dangerous, as well as the fact that the medication has side effects and that the benefits of medicating outway the disadvantages.
B. LTG: Goals met: Client deliberately sets up follow up plan and has been following a delivery system of self administration. This should be the friday of every week, and should coincide with when their dose of insulin runs out.

References
American Diabetes Association. (2016). 1. Strategies for Improving Care. Diabetes Care, 39(Supplement 1), S6-S12. doi: 10.2337/dc16-s004
The American Diabetes System outlines the various care system principles that can be applied to treat diabetes. They emphasize on patient centeredness as an effective manner in addressing the challenges that diabetes could brings. Communication for example could for example incorporate patient preferences and centered on improving their literacy, and numeracy and seek to address cultural barriers. Treatment decisions are also emphasized to be timely and evidence-based and patient should establish a support system and be motivated to see the importance. It should be noted that patients from different backgrounds come with a variety of issues, and perception that may hinder how they devise their care delivery system and how they view insulin therapy, all of which need to be timely and always done. As such, this article outlines to the reader a variety of ways in which the patient’s health should be prioritized for their well being. Diabetes will change their lifestyle completely, how they eat, how they do physical activities, what they eat, etc. and this article makes that very clear.
Gerada, Y., Mengistu, Z., Demessie, A., Fantahun, A., & Gebrekirstos, K. (2017). Adherence to insulin self administration and associated factors among diabetes mellitus patients at Tikur Anbessa specialized hospital. Journal Of Diabetes & Metabolic Disorders, 16(1). doi: 10.1186/s40200-017-0309-3
This article is focused on perception of treatment and insulin therapy in Ethiopia. It applies evidence based findings to outline the increased power of misconception and how it affects treatment of diabetes. Patients are discouraged by social pressures and even by their own psychological reaction to insulin therapy to become less likely to adopt self management regiment that are timely and regularly as advised by the doctor and this becomes dangerous for them. This article will be key in understanding how myths on insulin therapy can affect treatment.
Marcus, C. (2014). Strategies for improving the quality of verbal patient and family education: a review of the literature and creation of the EDUCATE model. Health Psychology And Behavioral Medicine, 2(1), 482-495. doi: 10.1080/21642850.2014.900450
This article outlines the effectiveness of communication and education for patient’s wellness. Diabetes changes one’s overall dynamics and it is encouraged that their social and cultural support system should become more involved in their treatment and self-medication at home. As such, these researchers emphasize on the need for education as a means to attain greater medical regiment. Their close family members as well as the client themselves need to be educated on the importance and processes involved in medical treatment and interventions of diabetes.
Perlmuter, L., Flanagan, B., Shah, P., & Singh, S. (2008). Glycemic Control and Hypoglycemia: Is the loser the winner?. Diabetes Care, 31(10), 2072-2076. doi: 10.2337/dc08-1441
In this article titled Glycemic Control and Hypoglycemia: Is the loser the winner?, the authors concentrate on educating the different types of people who are affected by the disease insulin treatment therapy. They identify that in some people, the treatment is without symptoms and in others, symptoms will manifest and affect how they react to treatment over the long term. The authors emphasize that symptoms that manifest on use of insulin over a long time is expected and normal for many patients. This article will be very important in outlining the effects that insulin could bring, as well as teaching the client some of the myths associated with treatment. While there are many myths, as listed in the document above, the article also shows the side effects of insulin and advices the client accordingly separating myth from fact.
Shrivastava, S., Shrivastava, P., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal Of Diabetes & Metabolic Disorders, 12(1). doi: 10.1186/2251-6581-12-14
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, and Jegadeesh Ramasamy discuss the proliferation of diabetes 1 and 2 across the world and the effects that come with the disease. They emphasize on the importance of self regulation post discovery of the disease and also establish an increase in awareness could be appropriate for better self- medication and management. They categorically emphasize on a change in lifestyle, and the permanency of treatment in individuals with the disease. They outline the various types of diabetes and the effects they have on the body. Their article is effective as it has on the body. This will be effective in providing a clear and definitive conceptual understanding of the disease and how or who it most affects and why.

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