Teaching Through Effective Speaking – Education Essay
As a nurse, there are many opportunities to teach patients and their families through effective speaking. How well I teach patients about wound care and management can have a direct impact on their quality of health. Wound care has many different aspects. My
responsibility is to teach and demonstrate the proper procedures to help the patient improve their quality of life. This involves teaching and speaking in small groups, which usually includes not only the patient but also members of their families. It is very important to make sure that the patient thoroughly understands the subject and can demonstrate the desired procedure back to me. Through my various teaching experiences, I have come to understand the importance of visual and vocal aspects in speech, active listening, and speech content.
Visual and Vocal Aspects of Speech
It is important to remember that how material regarding wound care is presented can be just as important as the material being presented. The physical delivery and verbal delivery help the patient to learn and understand the importance of wound care and management.
Concrete Experience
In my teaching experiences, I am teaching the patient and at least one member of their family. My job is to show the importance of performing the desired procedure properly to help improved the patient’s quality of life. I must show through my words and actions that I am knowledgeable and confident in the material and skills I want the patient to learn and perform.
When teaching, I prefer to sit at the same level as my patient and their family. It is also easier for me to demonstrate a technique and have the patient or family member demonstrate it back to me. Posture can make a big difference in teaching. I maintain a posture that is professional and shows confidence in what I am teaching. I stand or sit upright, but not too straight. I do not slouch or slump. I also use gestures to help emphasis key points and to demonstrate important techniques. I keep my gestures professional and do not make gestures that may be considered playful or derogatory. Eye contact is a key element to use when trying to teach someone. It helps me to judge if they understand the material, I am teaching. It is also important for me to keep my facial expressions neutral and friendly. The patient and their family need to understand the importance of the material being presented to them. Positive reinforcement can help to build confidence about material being learned.
It is also necessary for me to place verbal emphasis on key points. Not only the tone of my voice is important, but the rate and volume also have a great impact on helping patients learn. I make sure that I speak at an even rate and slow down to help emphasis key points. I make sure that I am not speaking to fast. A consistent rate helps to hold the attention of the patient. To emphasis key points, I also either speak a little louder or repeat the point several times. This helps the patient know that these are key issues to remember. I will also have the patient or their families explain the key points back to me. That way I can make sure they see things the way I am trying to explain them. It also helps to reinforce that they understand the concept and will be able to perform the procedure on their own. A positive attitude helps the learning process flow more smoothly. This along with positive reinforcement helps the patient to gain more confidence in handling their health problems.
Reflective Observations
Teaching can be an anxious time due to the environment and the fact that a major health even has recently occurred. Patients and their families seem to respond better when I am sitting at eye level with them and proceed slowly. This gives the patient and their families a chance to let the material I am teaching sink in. It also helps them to feel more comfortable about asking questions. If I slump in a chair, I can give off the impression that I am not interested in the patient or the material I am trying to teach. . It is also important that I do not cross my arms. This can be perceived as a negative attitude. I need to make the patient and their families realize that I care about their outcomes and that the material I am teaching is very important.
When I make eye contact, it shows that I am genuinely interested in teaching and helping the patient succeed. By maintaining eye contact, it seems to put the person at ease and makes them more likely to ask questions about things they do not understand. It is important to ask the patient and their family questions about material already taught. This helps to build their confidence and helps them to be more eager to learn. Having family members involved helps because sometimes they think of questions the patient has not thought of or vise versa.
My posture and gestures can directly influence how well a patient or family member learns. If I slouch or slump, my patients may see me as being sloppy, unfocused, or uninterested. If I seem uninterested, the patient or family member has a harder time understanding the concept. They may also not take the material seriously and feel that it is not important. I cannot be too serious or too laid back, either of these can cause anxiety for the patient. This makes a person less likely to understand the material being presented to them about wound care. It is also important to provide a lot of positive reinforcement to help the patient and family members develop confidence in their learning experience. If I only focus on the negative, learning can be greatly restricted.
I have noticed that patients and family members tend to notice key points that are repeated frequently or emphasized in a louder voice. Key points need to be presented in a manner that the patient or family member can easily understand. When the patient or family member repeats a key point in a later conversation, it reinforces that the teaching has been effective. It also helps build confidence in knowledge learned by the family member and the patient. I have observed that if I talk too fast my patients have more troubled comprehending the material being taught. I think this is because my words become mumbled and the patient looses interest.
Abstract Conceptualization
The eyes are said to be a key to the soul, therefore they are a very important part of teaching through effective speech. According to Ritts & Stein (2006), “eye contact helps regulate the flow of communication, signals interest in others, and increases the speaker’s credibility” (p. 1). This also helps to “open the flow of communication and convey interest, concern, warmth, and credibility” (Ritts & Stein, p.1). The eyes help to show that a speaker has confidence in what they are teaching. Eye contact also helps me to connect with the patient and their families. When I maintain eye contact with the patient, they are more likely to ask questions and be involved in the material I am teaching them.
According to Blair (1995), “the two most important aspects of the voice for a public speaker are projection and variation” (p. 6). By varying the tone and pitch of my voice, I can easily emphasize key points. This helps the patient and their families to see the most important points of the lesson. When teaching the lessons, I speak slowly and vary the tone of my voice. This keeps the patient and their families from becoming bored with the content. It also gives those being taught the opportunity to ask questions and to become more comfortable with the material being taught. Being able to establish an open atmosphere for learning with help the patients learn more effectively.
Active Experimentation
Each time I get the opportunity to teach a patient, I draw from my experiences to make the lesson easier to understand. When I first began teaching, I would read from note cards. I have learned that by maintaining eye contact and drawing from my own knowledge the patient is more relaxed and eager to learn. By sitting at eye level and teaching slowly, I give the patient the chance to ask questions openly.
I provide positive verbal reinforcement to help provide confidence to patients as they learn various procedures. This way, I am providing consistency in my teaching. Positive reinforcement can be as simple as a smile or a compliment when a key point is learned. I am always looking for ways to provide positive reinforcement in order to facilitate a better and more positive learning experience.
Recently when teaching a patient about wound care, I used variances in my voice to get across the key points I wanted the patient to learn. When I asked the patient to repeat back the instructions given to him, he was able to do them correctly. He later stated that the key points were easy for him to identify them, because my voice changed and he figured these must be important factors.
I have even used some of these techniques when singing with my church choir. I sing louder when wanting the congregation to understand how important a particular passage is to me. I also tend to sing slightly slower during moving passages to keep my words crisp and clear. My posture is straight, which shows that I am very interested in what I am singing. I keep my facial expressions appropriate for what material I am singing. If the material is upbeat, I tend to have a smile on my face. If the material is more somber, I am more reserved. I also maintain eye contact with the congregation. This shows that I am very interested in what I am singing and that I want them to understand the meaning of the song.
In communicating with my children, I have learned that by making eye contact they pay better attention to what I am saying. I also use voice variances with them to reinforce key points I want to make. I also speak clearly so that my children have no trouble understanding what I am trying to tell them. My sixteen-year-old son has mentioned several times to other people that he never has trouble understanding the important points in our conversation due to eye contact and the tone of my voice.
Active Listening
In my teaching, I have found that it is very important not only to teach effectively, but also to listen effectively. Active listening involves gathering and evaluating information. I must be attentive in listening to questions my patients have, listening to remarks they make during the teaching process, and listening for remarks between patients and their families. I need to listen carefully when a patient is repeating back instructions on wound care and management to me. If I do not correct an error or fail to hear it, this can lead to potential complications with wound healing.
Concrete Experience
In teaching proper wound care techniques, I am usually teaching a patient and at least one member of their family. When I am teaching, I allow the patient and any family members to discuss the information I am providing to them. I am attentive to comments, gestures, and posture of not only the patient but also their family. I listen to the questions my patients and their families have to ask and remain nonjudgmental.
I nod my head and make statements to show my patient and their families that I understand what they are telling me. I genuinely listen to what my patient has to say. I repeat back phrases to provide clarification not only for the patient, but also for myself. .
Reflective Observations
I was very nervous the first several times I taught wound care and management. I start by giving a short introduction to wound care and provided any handouts available to the patient. I then given the patient some time to review any written material I have given them. Next I give the patient time to ask any questions or voice concerns they may have. I make sure to clarify anything I do not understand before answering the questions. It is important for me to understand what the patient is trying to ask and to remain attentive to them. By restating back information to the patient when they ask questions shows the patient that I am actively listening to their issues. I devised a checklist to make sure that material being repeated back to me is correct. This way I can confidently move on to the next section or task. This has made me more comfortable with listening intently to what my patient and their families are saying.
Active listening is a part of my teaching. I listen for hesitancy in verbalizing key points and work to help reinforce those concepts. It is also very important to listen for any motivational barriers that could keep my patient from learning about wound care. In learning about wound care confidence seems to be a factor to learning. By providing positive reinforcement, I can help the patient and their families gain confidence in the material they are trying to learn.
Abstract Conceptualization
I have learned that for my teaching to be effective, actively listening must be included. In active listening, we are genuinely interested in understanding what the other person is thinking and/or feeling, and we are active in checking out our understanding before we respond. We restate or paraphrase our understanding of their message and reflect it back to the sender for verification. This verification or feedback process is what distinguishes active listening and makes it effective. They are often distracted, half listening, half thinking about something else. According to Youra (2004), paying attention to external distractions is critical for the speaker…try to address promptly any distractions your audience may fact” (p. 41). External distractions can include noise, temperature, and lighting. There are also internal distractions such as hunger or fatigue. I also use a checklist to make sure that no part of the wound care teaching is missed, since all areas are of equal importance. This simple checklist helps me to keep focused and to make sure that I am providing the patient and their family with all the needed information for a positive outcome
Active Experimentation
Personally, effective listening has been the hardest part for me to learn about teaching. I make a conscious effort to listen attentively to all conversations and questions that occur during the session. I try to have an environment that is conducive to learning and to make sure that distractions can be minimalized. I try to make sure to schedule my teaching after a patient has eaten and when they are less likely to be tired. It is important for me to not only focus on things that may distract my patient, but also things that may distract me.
My short introduction helps the patient to relax and start to focus on the task at hand. My checklist really helps me to remain focused and provides me with the ability to actively listen without distraction. The checklist keeps me aware of where I am in the teaching and allows me the freedom to let the patient ask questions and converse with family. This not only makes them more comfortable with me, but also more comfortable with the wound care teaching.
I practice active listening skills in other areas of my work as well. When I go in to assess a patient for the first time, I listen to their complaints and concerns. I give that patient my total attention; this helps me to meet their needs and expectations. I work on a medical/surgical unit that can become very hectic at times. It is important to always make the extra effort to listen to patients and their families. When orienting a new patient to our floor about the layout of the rooms, bed controls, and call bell system I have a mental checklist I go through to make sure nothing is missed. I then actively listen to the patient repeat back to me the information regarding our floor that I have just provided to them.
I also use active listening when dealing with my teenagers. They know that I am listening to all they have to say by repeating statements back to them for clarification, maintaining eye contact, nodding my head, and verbally expressing my attention. I can say short phrases such as I understand, I see what you mean, I hear what you are saying, or simply uh-huh. I have found that when I give them my total undivided attention they are happier and more receptive to constructive criticism.
Concrete Experience
Information presented regarding wound care can be very complex and overwhelming for patients and their families. I may only have a day or two to make sure my patient and their family understand the importance of proper wound care. I have to make sure my speech content is precise and to the point. My patients not only have to be able to verbalize comprehension of concepts, but also have to be able to demonstrate correct techniques for caring for the wound.
To prevent confusion or misunderstanding, I must present information in a clear, organized, focused manner. I have a checklist that I follow to make sure that all relevant information is presented. This keeps me focused and organized. I also give the patient and their family a copy of this checklist to take home with them. This helps them to be successful in performing the wound care on their own.
Prior to the teaching session, I also make sure that I know the education level of my patient. This way I can gear my wound care teaching to them. I teach in a manner that is easy for them to understand, yet make sure that they learn all the information they need to care for their wound. Some patients have had wound care teaching before and for some this is brand new. I make sure that my wound care teaching is performed according to hospital and physician specifications. Patients and their families must be very proficient in understanding the disease process and why the wound occurred, caring for the wound, performing dressing changed, recognizing complications, and knowing when to contact their physician.
At the end of my teaching session, I perform a short question and answer session with my patient. This gives me the chance to make sure that they have understood the concept and practicality of information that has been presented to them. They are also required to perform a dressing change. This gives me the opportunity to make sure they are able to care for their wound upon discharge. My patient feedback has been positive. Patients say they feel very comfortable with the material learned and will be able to care for their wound at home. Patients relate that having the material related and intertwined with their everyday lives makes the job of wound care easily for them to accept. It is very rewarding to receive a note several weeks later from the patient that they are doing well and their wound is healing well.
It is very important for me to stay focused and consistent in the information and procedures I am teaching. There is a wide variety of information that needs to be taught in wound care teaching and management. This includes why the patient has the wound, what risk factors were involved in creating the wound, specific wound care information, things the patient and family can do to improve wound healing, complications that can occur, reactions to complications that can occur, and what is the follow-up plan. Many of these steps involve the patient verbalizing knowledge, while there is also a need for demonstration of skills. One example is that a patient and their family can verbalize wound complications. These complications include a rash around the wound area, necrotic tissue, bleeding, and fever, drainage from wound, redness, or swelling around wound site. As an instructor, it is of the utmost importance for me to make sure they can list all potential complication.
Reflective Observations
When I first began teaching wound care, I was very overwhelmed by the responsibility. Wound care teaching can have a direct impact on the quality of life. It can mean the loss of a body part, continued hospitalization, or even death. I was not sure at first if I could handle the pressure involved with this type of teaching. I took several courses related to teaching wound care and observed several nurses teaching wound care prior to performing teaching on my own. This made me more comfortable in teaching wound care to patients.
I have noticed that if a patient feels anxious, it is very hard for them to comprehend the material I am trying to teach. Many patient are very concerned about how their wound and its care will affect their everyday life. By helping them to understand that wound care could be integrated into their everyday lives, it made teaching much easier. It has also been important to help the patient stay organized and focused during dressing changed. The checklist I provide to them seems to help them remain on track during the procedure. It helps to keep them calm and confident in the procedure they are performing.
Abstract Conceptualization
When teaching patients and their families, I try to teach in a manner that can relate the content to everyday life. Patients and their families want to know how the material I am teaching them is going to affect their everyday life. They also want to know how to integrate the changes they need to make into their current lifestyle. Sometimes I have to make sure that the patient is understanding that a major lifestyle change has to occur, while others times only minor change is needed. Lieb (1991) writes that adults are relevancy-oriented and must see a reason for learning something. If a patient can see how the outcome will improve their quality of life, they are more likely to take the teaching seriously. I also have to make sure that I am teaching the content on a level that can be easily understood. A teacher has the ability to enhance the material being taught or to make it harder to understand.
I am constantly reviewing the hospital policies for changes in wound care. This way the patient can receive the most update information available. Attending in-services on wound care is another way that I stay on top of new techniques. These new techniques can make wound care easier and more effective. Patients seem to be less anxious when the know that wound care techniques are always be refined and improved. I have learned that it is very important to minimalized anxiety in order for content to be appropriately learned. I work hard to create a good rapport with my patients. By established a good rapport, it helps the patient to trust in the my ability to teach wound care. According to Blair (1995), “you should plan exactly how you wish to appear…and establish that relationship. You may be presenting yourself as their friend, as an expert, perhaps even judge, but whatever role you choose you must establish it at the very beginning” (p. 4). My patients need to view me as an authority on wound care and also as their confidant. They need to be able to come to me with questions or concerns and know that I will deal with whatever issues they bring to me.
Lieb (1991), “the best way to motivate adult learners is simply to enhance their reasons to learn” (p. 2). I make sure that my patients understand the consequences of not learning and following the wound care instructions. I can stand and teach about wound care all day long, but unless my patient is grasping the concepts and key points, I am wasting time.
Active Experimentation
I have been teaching wound care for over 8 years now, first as a dialysis technician, and now as a registered nurse. The more times I teach and more classes I learn, the more proficient I become at teaching wound care. There have been many things I have changed over the years to be more effective as a teacher.
When I first began teaching wound care, I relied just on my personal experiences to teach. Now I use a checklist and materials provided by the hospital for wound care. I use this checklist technique not only for wound care, but for other professional teaching as well. The checklist helps to make sure that information is presented in a clear, accurate, concise techniques. It can also be used by the patient to help build confidence. This checklist can be easily updated when new techniques or concepts are introduced for wound care.
Preparation is also a major factor in good teaching. I make sure that I have all the material I need before entering a patient’s room. This helps to cut down on distractions. I have also learned to judge if my patient is actually ready to learn about wound care. If the patient is tired, hungry, or in pain they will have a very hard time learning any material I attempt to teach them. Organization goes along hand in hand with preparation. If I am disorganized, they patient may become distracted or feel that I do not really know about wound care. By helping my patient decrease anxiety, I am actually helping them to comprehend and retain what I am teaching them.
I use preparation and organization frequently in both my professional and personal lives. I have three teenage boys and remaining organized is an important part of keeping our household running smoothly. The smallest amount of disorganization can lead to major upheaval. My family has chore lists that help to keep our household organized and running smoothly. I also use preparation and organization to make basic assessment flow smoothly. By having all the tools I need and following a systematic plan, an assessment can be completed quickly and thoroughly.
Conclusion
The experience of teaching has been extremely valuable to me not only in my professional life, but in my personal one as well. It is very rewarding to watch a person grasp a new concept that can greatly improve their quality of life. I have learned how to make my patients and their families feel comfortable and less anxious about wound care. I am now much better at organizing and prioritizing my thoughts and actions. By becoming a better active listener, I have been able succeed in my professional endeavors and have improved my personal relationships as well.
References
Blair, Gerard. Presentation skills for emergent managers. 1995. University of Edinburgh. 20 Nov. 2006
Lieb, Stephen. Principles of adult learning. 1991. Honolulu Community College. 20 Nov. 2006
Ritts, V. & Stein, J.R. Six ways to improve your nonverbal communication. 2001. Honolulu Community College. 20 Nov. 2006
Youra, Paula. A speaker’s guidebook. 2004. Bedford St. Martin’s. 10 Dec. 2006.