Background
The aim of adult education is to impart practical skills and knowledge that a learner can apply in his or her life. Low literacy skills in functionally illiterate individuals prevent them from living healthy and productive lives (Eme, 2011). Such learners have special needs, which include limited reading and writing skills, low motivation, and mental exhaustion, which means that they cannot learn effectively in conventional learning environments.
For diabetic clients, adult education modeled around self-care can equip the individual with skills and adaptive behaviors to manage the condition. Self-management skills enable clients to do functional activities that help in the management of the condition. As with other functionally illiterate adults, a diabetic client faces three challenges that the proposed teaching plan will address. These include difficulties in managing symptoms, performing their functional roles, and handling their emotions (Rigdon, 2010). In this view, learning should center on promoting healthy eating, physical activity, coping mechanisms, glucose monitoring, and therapeutic interventions. This paper describes a teaching plan for a 65-year old diabetic who is functionally illiterate and therefore, requires skills to manage his condition.
Goals and Objectives
The goals of this teaching plan include:
- To teach the diabetic client self-care methods and behaviors, such as diabetes diet and insulin self-injection, that would enable him to play a central role in the management of his condition.
- To inform the client of the importance of partnerships with diabetes care centers, fitness facilities, and community health promotion programs that treat diabetes-related complications.
- To help the client to identify clinical, educational, and behavioral goals that can improve his health outcomes. The client-centered approach will help in evaluating the progress of the program.
The objectives that have to be met to achieve the goals of the teaching plan include:
- To increase the client’s nutritional knowledge so that he knows the food types that should be included in his meals. He should be able to demonstrate sufficient knowledge of the different food groups and their nutritional contents within the next three months.
- To increase the client’s knowledge of the importance of physical activities and fitness training in diabetes management.
- To increase the client’s knowledge of prescription drugs and over-the-counter treatments he can use to manage the symptoms that may arise.
- To educate the client on how to monitor blood glucose levels at home.
Behavioral Objectives
A behavioral objective consists of four components, namely, condition, performance, criterion, and who will do the performance. The behavioral objectives for this teaching plan include:
- The client will be able to adopt a healthy lifestyle after completing a lesson about self-management interventions (insulin therapy) that improve quality of life, as taught by a home care nurse.
- The client will be able to develop confidence after the training to avoid risky behaviors to prevent diabetes-related complications that affect health outcomes, as instructed by community health providers.
- The client will become more knowledgeable about metabolic outcomes, including blood glucose level and blood pressure, after a symptom detection lesson taught by a home care nurse.
- The client will be able to identify the food groups to consume a diabetic diet that will improve his health outcomes after going through a lesson taught by a dietician.
- The client will be able to design an exercise module that will help him achieve the required fitness level as instructed by a trainer.
Domains of Adult Learning
By identifying the learning domains, an instructor can design the activities, instructional materials, and teaching strategies that enhance the mastery of the educational outcomes. There are three learning domains, namely, psychomotor, affective, and cognitive.
The Cognitive Domain
It centers on cognitive skills (thinking) that learners acquire during learning. Eme (2011) outlines the six skills or levels of this domain as “knowledge, comprehension, application, analysis, synthesis, and evaluation” (p. 755). The domain is an essential learning objective, as the other two domains often involve a cognitive element. It can be achieved through face-to-face interactions or online media. When the learners reach higher cognitive skills, i.e., synthesis and evaluation, they are able to perform problem-solving activities and make effective decisions.
Knowledge describes the learner’s ability to recall the material learned in class (Eme, 2011). As a lower cognitive skill, knowledge enables learners to recognize, define, and describe concepts or phenomena. In contrast, comprehension is the capacity to comprehend taught concepts. This skill enables students to compare ideas, explain concepts, and organize information into a coherent form. ‘Application’, which is a higher cognitive skill, refers to the ability to utilize material learned in practice. Students with this skill have the ability to use learned information to solve problems or find answers to questions. The other higher cognitive skill is ‘analysis’, which describes the learner’s understanding of the relationships between various components or concepts. Critical thinking skills and self-reflection fall under the analytical dimension of the cognitive domain. An analytical mind understands the causes, effects, or rationales for a particular situation. This often involves the analysis of learned information to infer about unknown situations. Synthesis is a higher cognitive skill that entails deductive reasoning. It gives a learner the ability to develop a whole idea from the material learned in class. It encourages learners to be creative in designing or predicting an outcome based on known information. In contrast, ‘evaluation’ is the ability to assess things based on certain standards. The evaluation skill enables a learner to judge a piece of work based on some criteria or standard.
The Affective Domain
It centers on individual feelings or attitudes that are crucial in learning. It encompasses the “attitudes, motivation, and willingness” to value the course content and utilize it in one’s life (Wang & Ku, 2010, p. 614). The affective domain consists of five stages, namely, receiving, responding, valuing, organizing, and characterization (Wang & Ku, 2010).
Receiving is the willingness to pay attention. In this regard, the learner is attentive to learning activities occurring in class. Receiving dimension means that the learner is attentive or aware of all classroom activities (Wang & Ku, 2010). Responding describes the learner’s level of participation. It means that the learner reacts or shows interest in class activities by adhering to rules, working with others, and doing his/her homework. By comparison, valuing is the disposition to be actively engaged in classroom activities. A learner who values the program attaches some level of worthiness to the course. He or she appreciates the material learnt and shows a commitment to improve his or her grades. Organization is the ability to interact with the content. In this regard, an organized learner is one who formulates plans to solve problems and synthesizes different values to develop an individual perspective. On the other hand, characterization describes one’s willingness to adopt a behavior change (Wang & Ku, 2010). It requires one to develop a good value system characterized by self-reliance and healthy lifestyles.
The Psychomotor Domain
This domain centers on action-oriented motor tasks performed in a learning environment. Its aim is to promote a learner’s mechanical abilities, such as smoothness, rapidness, and accuracy, which are useful in performing psychomotor activities. It is useful in physical education, technical training, and performing arts. The domain consists of four stages, namely, action, coordination, formation, and production. Action describes basic bodily movements while coordination entails synchronized movements. Formation describes the movement of the whole body while production combines verbal and nonverbal elements during a learning activity (Williams, 2012). Psychomotor training requires basic cognitive skills. It can be done through face-to-face interactions, text descriptions, or simulations.
The psychomotor domain covers many behavioral attributes. The first one is perception, which relies on the senses to bring about a psychomotor response. It also entails attitude, which describes the emotional, physical, and mental factors that influence one’s response (Williams, 2012). Psychomotor learning also entails a guided response, which describes the repeated experimentation that leads to improved performance. The domain also involves a mechanism for learning a new skill. Individual movements during psychomotor training can be overt or adaptive. Overt movements involve less effort while adaptive ones are adjustable to different situations.
The main aim of the teaching plan is to enable the client to recognize complications, achieve the recommended dietary habits, and adopt self-management techniques. Individual instruction and ongoing assessments can enhance the patient’s cognitive skills. On the other hand, psychomotor training in glucose monitoring and insulin self-injection can enhance the client’s health outcomes. In this view, the instructional methods and resources will be structured to appeal to the three domains. Creating a learning environment that offers interesting experiences to support and motivate the client to change his behavior is also important.
Instructional Methods
Adult learners, unlike children, need information that has immediate usefulness and relevant to their situation (Williams, 2012). With regard to psychomotor training, it should be safe, engaging, and offered in a respectful manner. It is also important to rely on their experiences and self-assessments to evaluate their skills in the three domains.
The Cognitive Domain
The instructional methods that reach the adults’ cognitive domain are those that involve their observations/experiences and participation. According to Eme (2011), adults acquire cognitive skills by participating and observing. Observation enhances the retention rate, which enables learners to perform common functional activities. Eme (2011) recommends three strategies that educators should use when instructing functionally illiterate adults, namely, teaching only a small amount of content at ago, being vivid when explaining concepts, and using periodic reviews. A skill, such as insulin self-injection, should be taught first before giving the principles of the procedure. On the other hand, educators should use short and precise statements, illustrations, headings and subheadings, and summaries to enhance the vividness of their explanations. Periodic reviews help indicate whether the learners have reached the required cognitive level.
For the diabetic client, the instructional methods for teaching cognitive skills include the use of videos, demonstrations, and lectures. Demonstration is a learning session that entails a particular procedure. Asino (2014) writes that through demonstrations, a learner acquires application and synthesis skills. In contrast, a formal lecture entails a presentation that does not involve much instructor-learner interactions. Through lectures, learners acquire lower cognitive skills, such as knowledge and comprehension. On the other hand, group discussions provide a forum for the exchange of ideas between learners.
The cognitive domain resonates well with multimedia aids. In this view, information communication technology can be used to supplement lectures that tend to reach the cognitive domain (Asino, 2014). The supplemental instructional resources include graphics to illustrate connections between concepts, PowerPoint slides, case studies that depict real-life scenarios, and simulations to explain complex ideas. Instructors can also use self-check quizzes, discussion boards, and class notes to reach the lower levels of the cognitive domain. Honebein and Honebein (2014) argue that the strategies for reaching higher cognitive levels, i.e., synthesis and evaluation, must involve projects or problem-based tasks. This may involve face-to-face interactions or the use of online tools, such as video conferencing or webcasting.
The Affective Domain
Instructors expect learners to participate in classroom activities and to value the material taught in class. Thus, the instructional methods that reach the affective domain are those that involve goal setting, self-reflection, and tutorials that offer deeper insights into a concept. In this view, face-to-face meetings, including classroom lectures or demonstrations can be used to reach the affective domain, which is largely dependent on individual goals. Hou (2012) notes that an online course can reach the affective domain, but it must be preceded by classroom lectures.
Besides face-to-face meetings, motivational videos also engage the affective domain. This may include teaching affective skills through audio and video messages from previous learners talking about their learning experiences. The videos can also carry the instructor’s views about the value of the subject. This can motivate the learners to value the course content and apply the material learnt in class in their lives.
The characterization dimension of the affective domain allows learners to apply learned material in their lives. In this regard, streaming video or audio clips of professionals testifying how the subject has changed their lives can engage the affective domain of the learners (Wang & Ku, 2010). Additionally, instructors can use short audio/video clips to give an overview of the course, provide tips on how to study the program, explain content, and encourage learners to work hard.
Another instructional strategy for affective learning involves interactive online forums. Class lectures should include an online component that allows learners to ask questions and receive responses from the instructor. Additionally, learners can receive encouragement (textual) and content from the instructor through webcasts and video conferencing. Another method involves helping learners to set individual goals to improve their affective outcomes.
The Psychomotor Domain
The instructional methods that enhance psychomotor learning are those that involve face-to-face interactions. This stems from the fact that motor skills often involve certain components of the cognitive domain. According to Roberson (2014), to engage the psychomotor domain, instructors must encourage the “practice of the desired skill with feedback and arrange learning activities in the correct order” (p. 344). In this view, instructors can use videos and demonstrations to teach motor skills. Textual and pictorial resources also enhance the development of motor skills.
Another instructional approach involves the use of simulations to teach the learner sequential motor activities. However, the instructor must evaluate the learner to determine whether he or she has perfected the skill. Simulations are useful in situations where the training equipment for a particular motor activity is absent or unsafe. New learners must practice with the actual equipment under the supervision of the instructor to perfect the skill.
References
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Eme, E. (2011). Cognitive and Psycholinguistic Skills of Adults who are Functionally Illiterate: Current State of Research and Implications for Adult Education. Applied Cognitive Psychology, 25, 753–762.
Honebein, P., & Honebein, C. (2014). The influence of cognitive domain content levels and gender on designer judgments regarding useful instructional methods. Educational Technology Research & Development, 62(1), 53-69.
Hou, H. (2012). Analyzing the Learning Process of an Online Role-Playing Discussion Activity. Journal of Educational Technology & Society, 15(1), 211-222.
Rigdon, A. (2010). Development of Patient Education for Older Adults Receiving Chemotherapy. Clinical Journal of Oncology Nursing, 14(4), 433-441.
Roberson, S. (2014). Improving Teaching and Learning: Three Models to Reshape Education Practice. Education, 134(3), 340-358.
Wang, C., & Ku, H. (2010). A case study of an affective education course in Taiwan. Educational Technology Research & Development, 58(5), 613-628.
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