Evaluating teaching and learning

Evaluation, the last phase of the teaching process, is the ongoing appraisal of the patient’s learning progress during and after teaching. The goal of evaluation is to find out if the patient has learned what you taught.

Here are some ways you can evaluate learning:

• Observe return demonstrations to see whether the patient has learned the necessary psychomotor skills for a task
• Ask the patient to restate instructions in his or her own words
• Ask the patient questions to see whether there are areas of instruction that need reinforcing or re-teaching,
• Give simple written tests or questionnaires before, during, and after teaching to measure cognitive learning
• Talk with the patient’s family and other health care team members to get their opinions on how well the patient is performing tasks he or she has been taught
• Assess physiological measurements, such as weight and blood pressure, to see whether the patient has been able to follow a modified diet plan, participate in prescribed exercise, or take antihypertensive medication
• Review the patient’s own record of self-monitored blood glucose levels, blood pressure, or daily weights
• Ask the patient to problem solve in a hypothetical situation

Documenting patient teaching

Your documentation of patient teaching should take place throughout the entire teaching process. Documentation is done for several purposes. Documentation promotes communication about the patient’s progress in learning among all health care team members. Good documentation helps maintain continuity of care and avoids duplication of teaching. Documentation also serves as evidence of the fulfillment of teaching requirements for regulatory and accrediting organizations such as the JCAHO, provides a legal record of teaching, and is mandatory for obtaining reimbursement from third party payers. Documentation of patient teaching can be done via flow-charts, checklists, care plans, traditional progress notes, or computerized documentation. Whatever the method, the information must become a part of the patient’s permanent medical record. Table 6 shows suggestions on what to document and how.

Table 6

Documenting Patient Teaching

What to document The patient’s learning needs The patient’s preferred learning style and readiness to learn The patient’s current knowledge about his or her condition and health care management Learning objectives and goals as determined by both you and the patient Information and skills you have taught Teaching methods you have used, such as demonstration, brochures, and videos. Objective reports of patient and family responses to teaching Evaluation of what the patient has learned and how learning was observed to occur How to document Record the patient’s name on every page of your documentation. Include the time and date on all entries. Sign each entry. Write in black or blue ink, for legal and reproduction purposes. Write legibly. Be accurate and truthful when discussing facts and events. Be objective-don’t show personal bias or let others influence what you write. Be specific. Be concise-record information succinctly, without compromising accuracy. Be comprehensive-include all pertinent information. Record events in chronological order. Source: Rankin, S.H., & Stallings, K.D. (1996). Patient Education: Issues, Principles, Practices, 3rd ed. Philadelphia: Lippincott-Raven, 233-236.

Developing an effective teaching style