Health education and adult
learning
Professor Tarek Tawfik Amin
Public Health
Cairo University
amin55@myway.com

Objectives:
At the end of the session, trainees would be able to:
1- Define the basic rules forproviding health education.
2- Get oriented with principles of adult learning.
3- Appreciate the practical roles forprocesses involved in
adult learning.

Principles of Patient Education
Peopleareexpected to learn enough about their
own health to beableto participatein health
caredecisions.
Patient education haschanged from telling the
subject thebest actionsto take, to assisting them
in learning about their health care for thesakeof
improvement.
Racial, cultural and ethnic differencesplay a
largepart in thecommunication process.

Principles of Patient Education
Two important principlesfor providing patient
education aresimplicity and reinforcement.
"Simplicity" meansthat educational messages
must bedelivered so thesubject can readily
understand them.
Health education can includeextremely
intricateinformation (e.g., triplescreening,
amniocentesis, and Rh incompatibility).

Principles of Patient Education
Start by assessing what thesubject knows
beforeteaching.
Never assumethat thepatient needsto be
taught everything about atopic.
Over teaching must beavoided.
It isfar better to choosethreeor four essential
conceptsabout atopic.

Principles forProviding Patient Education
Simplicity
1.Teach the simple concepts about a topic first, and then move to the
more complex concepts.
2. Use language that the woman will find easy to understand and
avoid medical terminology wheneverpossible.
3. Use words that mean something to the general public. The word
"positive" has a good connotation formost people, but in health issues,
sometimes "positive" means a bad finding; this can be very confusing
forourpatients.
4. Use concrete language and tell them exactly what you want them to
do, such as "call me if you feel any fluid leaking from yourvagina," not
"call me if yourwaterbreaks."

Principles forProviding Patient Education
Reinforcement
1.Teach the one concept you want yoursubjects to truly learn first in
the lesson, and then teach that same concept again last.
2. Ask subjects to re-state what you have taught them, so you can
be sure they understood.
3. Use visual aids forteaching; using several senses improves
learning.
4. Always use written educational materials forthe subjects to take
home.

Knowles adult learning principles
 Knowlesformulated what hecalled the "Adult
Learning Principles".
 They remain today essential knowledgefor
peoplewho teach adultsin health settings.
 Theseadult learning principlescan help usto
plan effectivehealth education programs.

Knowles adult learning principles
1. Adultslearn best when thereisa perceived
need.
2. Progressfrom theknown to theunknown.
3. Alwaysassesswhat they know about atopic
beforebeginning ateaching session.
4. Don't re-teach thethingsthey already
understand.
5. Progressfrom thesimpler conceptsto more
complex topics.
6. Adultslearn best using activeparticipation.

Knowles adult learning principles
7. Adultsrequireopportunitiesto practicenew
skills.
8. Adultsneed thebehavior reinforced. Teaching
about health topicsneedsreinforcement
continually.
9. Immediatefeedback and correction of
misconceptionsincreaseslearning.
10. Alwaysask thesubject to restatewhat you
havetaught.
Adapted fro m Kno wles, 1 98 0

Adult-Learning Principles Introduction
o Knowlesalso described adult learning asa
processof self-directed inquiry.
o Six characteristicsof adult learnerswere
identified by Knowles(1970).
o Headvocated creating aclimateof mutual
trust and clarification of mutual expectations
with thelearner.

Characteristics of adult learners
ΩAutonomousand self-directed
ΩAccumulated afoundation of
experiencesand knowledge
ΩGoal oriented
ΩRelevancy oriented
ΩPractical
ΩNeed to beshown respect
Knowles 1970

Adult-Learning Principles Introduction
 Thereasonsmost adultsenter any learning
experienceisto createchange.
 Thiscould encompassachangein
(a) their skills,
(b) behavior,
(c) knowledgelevel, or
(d) even their attitudesabout things
(Adult Educatio n Centre, 2005).

Adult-Learning Principles Introduction
 Compared to school-agechildren, themajor
differencesin adult learnersarein:
a) thedegreeof motivation,
b) theamount of previousexperience,
c) thelevel of engagement in thelearning process, and
d) how thelearning isapplied.
 Each adult bringsto thelearning experience
preconceived thoughtsand feelingsthat will be
influenced by each of thesefactors.
 Assessing thelevel of thesetraits-readinessshould be
included each timeateaching experienceisbeing
planned.

Pillars of adult learning.
Adult Learning
MotivationExperiences
Engagement

Adult-Learning Principles 1- Motivation
o Adults learn best when convinced of the
need forknowing the information.
o Often a life experience orsituation
stimulates the motivation to learn
(O'Brien, 2004).
o Meaningful learning can be intrinsically
motivating.

Adult-Learning Principles 1- Motivation
o The key to using adults' "natural"
motivation to learn is tapping into their
most teachable moments (Zemke &
Zemke, 1995).
o Lieb (1991) described six factors which
serve as sources of motivation foradult
learning.

Sources of motivations
1. Social Relationships: to makenew friends; to meet a
need for associationsand friendships.
2. External expectations: to comply with instructionsfrom
someoneelse; to fulfill recommendationsof someone
elsewith full authority.
3. Special welfare: to improveability to servemankind; to
improveability to participatein community work.
4. Personal Advancement: to achievehigher statusin a
job; to secureprofessional advancement.
5. Escape/Stimulation: to relieveboredom; providea
break in theroutineof homeor work.
6. Cognitive/interest: to learn for thesakeof learning to
satisfy an inquiring mind.
Leib, 1991

Motivation
Health care providers involved in
educating adults need to convey a desire
to connect with the learner.
Providing a challenge to the learner
without causing frustration is additionally
important.
Above all, provide feedback and positive
reinforcement about what has been
learned (Lieb, 1991).

Experience
Adults have a greaterdepth, breadth, and
variation in the quality of previous life
experiences than youngerpeople.
Past educational orwork experiences may
colororbias the patient's perceived ideas
about how education will occur.
Formerexperiences can assist the adult to
connect the current learning experience to
something learned in the past.
This may also facilitate in making the
learning experience more meaningful.
(O'Brien,2004).

Experience
However, past experiences may
actually make the task harderif these
biases are not recognized as being
present by the teacher.
This would be an opportune time to
address any erroneous or
preconceived ideas.

Level of Engagement
 When an adult learner hascontrol over the
nature, timing, and direction of thelearning
process, theentireexperienceisfacilitated.
 Adultshaveaneed to beself-directed,
deciding for themselveswhat they want to
learn.
 They haveagoal in mind and generally takea
leadership rolein their learning.
 Thechallengefor teachersisto encouragethe
learner with reinforcement.
Rogers (1969)

Level of engagement
According to Rogers(1969), theadult-learning
processisfacilitated when:
1. Thelearner participatescompletely in the
learning processand hascontrol over its
natureand direction.
2. It isprimarily based upon direct
confrontation with practical, social, or
personal problems.
3. Self-evaluation istheprincipal method of
assessing theprogressor success.

Level of engagement
It isimportant to remember that in order to
engagetheadult learner and facilitatethe
transfer of knowledge, patienceand time
on thepart of theteacher and patient are
needed.

Applying the Learning: readability
o Verbal patient education should alwaysbe
accompanied by written information.
o It can bedifficult to find information written at
theappropriatereadability level, containing
theappropriateinformation, and in the
languagethewoman understands.

Readability
o Health education materialsdeveloped for the
general public should not exceed sixth to
eighth gradelevels.
o Materialswritten at readability levelsof sixth
to eighth gradearemoreeffectivein
conveying health messagesand havehigher
ratesof recall acrossall educational levels.

Readability
o Somepopulationsof women havespecific
problemswith written health education
materials, especially women with low literacy
skills.
o It isclear that women with low literacy skills
requirespecial interventionsto help them
learn.

Readability
o Educational materialsgiven to clientsshould
beculturally competent.

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Thank you