Resource Book

Teaching Skills Competency

For home visiting or other individual/ family teaching situations. This competency is not intended for group instruction situations.

Successful staff verbalizes and demonstrates

Assessment of learning needs

Assessment of client motivation

Clear sense of objectives

Providing relevant, accurate information

Evaluation of learning/ understanding

The competency is comprised of 3 skills:

I. Staff demonstrates knowledge of accurate, current information I the required area.

II. Staff demonstrates an ability to engage in the client oriented learning process.

III. Staff demonstrates knowledge of and the ability to use communication skills.

It is recommended that direct staff observation and discussion be used to validate this competency. However, if observation is not a choice, the following role plays may be used:

The nurse is visiting a 22 year old client who has just delivered a healthy baby boy (3 days old). She had tried breastfeeding in the hospital, but is bottle feeding the infant when the nurse arrives. This client lives with her sister and her sister’s two children (2 and 5 years old.) The client is alone with the three children. The two older children are watching TV. (Skill II)

The nurse is visiting a cognitively challenged mother who presents the problem of her infant’s diaper rash that is raw and bleeding. She has been treating the rash with corn starch because her mother told her that this solution always worked for her. (Skill III)

I. Staff demonstrates knowledge of accurate, current information in the required area.

Answers will depend on the specific clinical area being addressed during the observation/ evaluation.

Section A should reflect resources available to staff within the agency: resource books, relevant journal articles, and/or available consultants

Section B should reflect a knowledge of your agency source of educational materials, other care providers in the system of care, and/or other agencies that might provide related services.

Skill I is passed if responses reflect the current resources in your agency and community. This competency can be used for any client problem category, but reflects the ability of staff to identify and use available resources.

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II. Staff demonstrates an ability to engage in the client oriented learning process.

Section A:

Prioritization of intervention is based on

Conversation/ issues initiated by the client

Client interest (asks related questions, responds with examples) or

Observation of immediate need (safety, immediate medical issues)

Section B:

Methods of offering material may be:

Role play/ modeling

Verbal instruction/ discussion

Demonstration/ practice

Written materials

Audio-visual materials

Redman p. 45-65; 67; 205-206

Learning styles might include:

Behavioral (psychomotor/ kinesthetic)

Cognitive (problem solving)

social-cognitive (group attitude/ values)

Transfer of past learning (need to build on what is familiar)

Redman p. 20-24

Factors that affect learning/ progress toward goals may include:

Level of risk/ acuity of the problem (may increase urgency or avoidance)

Other over-riding issues (another more urgent problem acting as a distraction)

Timing is "off" (client is not yet interested; client was asking a different question)

Presentation style is off (client doesn’t read; teaching/ language is not at the client’s attention/ learning level)

Cultural values/ client determination (client specifically does not want to work on the issue)

Strength of relationship (client is not feeling safe/ trusting).

Redman p. 90; 206

 

 

II. Staff demonstrates an ability to engage in the client oriented learning process. Cont.

Section C:

Movement toward goals may be measured by:

Direct observation of behavior/ change

Client self-report

Response to open-ended questions

Critical incidents

Anecdotal notes demonstrating change over time.

Redman p. 82-83

Section D:

Engages client in exploring areas of learning NOT yet identified by client

Opens discussion with non-threatening statements (I’ve been thinking about....; some people wonder about....; do you ever think about.....)

Comments on immediate concern (I wonder if we could talk about.....since that will be coming up for you soon.)

Demonstrates ability to link themes; encourages conversation around topics that the client has been unable to initiate

Comments on observations or threads in the conversation (It seems like we talk a lot about....; I wonder if you have been thinking about/ working on....; I notice that [some behavior]. I wonder if that fits with ....[some previous discussion].

Skill II is passed if:

Section A skills 1, 4, and 5 are observed and if written/verbal response reflect the concepts of problem identification and prioritization.

Section B interpersonal skills are demonstrated and written/verbal responses reflect the 6 of the concepts above.

Section C written/verbal response reflect 3 of the five concepts.

Section D is a higher level competency. Staff must recognize the issue on the first competency. On the second review both skills must be demonstrated.

 

 

III. Staff demonstrates knowledge of and ability to use communication skills.

Section A

Demonstrates attuned communication skills

Makes appropriate eye contact with client

Body language is attentive/ open (body is still, relaxed, faces client, not intrusive)

Listens without interrupting

Offers/ respects privacy

Cues that teaching should be modified:

Client non-verbal language is rejecting (restlessness; turns away; loses eye-contact)

Client interrupts, changes subject

Client loses interest; attention is elsewhere

Client repeats phrases without modification; nods without verbal elaboration)

Staff behaviors that commonly create barriers

Failure to listen

Failure to probe/ explore further

Parroting/ repeating client’s exact words

Reassuring (particularly false reassurance)

Defending

Giving advice

Approving/ disapproving statements

Sundeen, et al p. 132

Section B

Factors that influence the way in which material is presented

Culture

Literacy level

Cognitive/ motoric development

Social-emotional development

Client/ family value system

Differentiation between clients in similar situations, staff describe clients with

similar diagnoses, cognitive development, social-emotional development and/ or culture

different needs and/or learning styles

III. Staff demonstrates knowledge of and ability to use communication skills. cont.

Section C

Demonstrates techniques that create shared communications

Validation

Reflective listening

Clarification

Identifies circles of communication (Recognizes and responds to verbal and non-verbal cues in a way that promotes movement in the communication process)

Manages conflict

Acknowledges different points of view/ attitudes

Acknowledges needs of client and care giver

Maintains client’s right to self determination

Remains non-defensive both verbally and non-verbally

Skill III is passed if:

Section A: Technical, interpersonal, and critical thinking skills are observed and 3 of the concepts are identified

Section B: Technical, interpersonal skills, and at least one critical thinking skill is observed. Three correct factors are listed in the written response.

Section C: Technical and interpersonal skills are observed or 4 concepts of written response are identified.

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