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Broad Instructional Goals
Patient Education
Hypertension or high blood pressure is a widespread disease that, without careful observation of the patient, can result in serious complications or even fatal outcomes. According to Wilkins et al. (2010), 22.6% of Canadian adults have hypertension, and 20% have prehypertension (p. 42). In order to control the blood pressure and the heart rate, the patients need to follow specific instructions and avoid any possible complications. The instructional goals for patients include:
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patients should be aware of hypertension, its symptoms, and risk factors
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patients should be able to take notice when their health status changes and detect the risks
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patients should understand how to monitor their blood pressure and what actions can be taken in pre-hospital circumstances
Family Education
The help of the relatives and family members is important to any patient. In some situations, patients can help themselves, but in other ones, more crucial or life-threatening, the support and engagement of the family are needed. The instructional goals for family education are the following:
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family members need to know how to measure blood pressure and heart rate
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family members need to recognize the signs of hypertensive crisis and provide necessary help
Staff Development
Medical staff can have a key role in the outcome of a hypertensive crisis, so, to prevent or handle hypertension, staff development is necessary. As Johnson, Nguyen, and Patel (2012) state, to improve the process of the patients self-monitoring, nursing staff has to take part in this process too (p. 538). That means the staff can not only help the patients control their blood pressure but also encourage them to be more attentive to their health. These are the instructional goals for the development of the staff:
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the staff should provide access to medical care for the patients
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the staff should raise awareness of hypertension crisis and complications of the disease among patients
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patients and their family should be informed by the staff about possible means of maintaining blood pressure in a normal range
Behavioral Objectives Based on Blooms Taxonomy
The behavioral objectives were devised, among others, by Benjamin Bloom. These objectives include three domains that comprise cognitive, affective, and sensory learning (Stanley & Moore, 2013, p. 1). Blooms taxonomy is a classification of cognitive skills; it depicts various types of thinking, but none of them is easier than the other because they are used during different activities (Stanley & Moore, 2013, p. 3). The list of the major objectives for patients is presented below.
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Objective one: Define the symptoms and risks of hypertension
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Objective two: Summarize the signs of change in health status
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Objective three: Model the pre-hospitalization situation and demonstrate self-care skills
The objectives for the family are different, but can relate to the patients objectives:
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Objective one: Illustrate how to measure blood pressure and heart rate
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Objective two: Outline the signs of hypertensive crisis and show what first aid might be given to a patient
The objectives for the staff are focused on teaching the patients and their family to prevent or cope with hypertension:
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Objective one: Organize and plan access to medical care for the patients
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Objective two: Discuss the high blood pressure and hypertension crisis with the patients and their family
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Objective three: Propose different types of diets and lifestyle programs to patients with hypertension
The primary goal for patients and their families is to recognize the signs of hypertension and know how to handle them, while the staff should provide necessary health care and instructions for patients.
Instructional Methods and Evaluation of Learning
Patient Education
Lesson Content
The objectives of this lesson will focus on defining the symptoms and risks of hypertension, understanding of how health status can change, and what are the signs of it, as well as demonstrating the comprehension of self-care skills. The lesson content will include the risks of hypertension, means of monitoring health status, and presentation of self-help skills. Age, race, family history, smoking, or an unhealthy diet are the risk factors (Carter & Black, 2013). Self-care includes self-monitoring, exercise, and diet.
Sequence for Teaching Activities
The sequence for teaching activities will include group discussions, personal studies, and surveys (if needed) of the patients, and lectures/discussions of literature and patients experience. The participants will be allowed to conduct interviews with each other and complete personal researches together or individually.
Instructional Strategies
To describe the symptoms and risks of hypertension, videos, and articles will be used. To understand the monitoring of the health status, charts from associated researches will be provided. Self-care can be explained by the medical staff and introduced to the patients via videos and brief lectures.
Time Allocation
Each of the activities demands a different amount of time to be completed. Group discussions will take up to two and a half hours every week, but their durability may vary depending on the demands of the participants. Teaching (lectures and discussions of literature) will take three hours; all participants will be reminded of the importance of such lectures for their health. Time for personal studies and surveys will be arranged by the participants independently.
Instructional Resources
Various books on hypertension will be used, as well as research studies and experimental studies that will be introduced to the participants. To simplify the professionally-oriented information, presentations will be used during the teaching. Mobile apps for measuring the heart rate will also be presented to the participants. To model the pre-hospital situation, videos and audios about the hypertensive crisis will be presented.
Evaluation
Interviews and tests will be used to understand if the lesson was successful. Participants may also try to answer the questions from medical staff, but only if they are willing to do so. The results will be used to suggest new ways of effective teaching.
Family education
Lesson Content
In this lesson, the objectives aim to teach the family members to measure heart rate and blood pressure of patients, recognize the signs of hypertensive crisis, and understand how it can be prevented or handled before the ambulance arrival. Neglecting of medication and poor control of chronic hypertension may cause a hypertensive crisis (Johnson et al., 2012, p. 541). Skills to measure the blood pressure, instructions to medications, and information about the first aid will be discussed at the session.
Sequence for Teaching Activities
The first activity will include the instructing of the family members about the measuring of heart rate and blood pressure. The participants will try to measure the blood pressure of other participants. The discussion of the hypertensive crisis will also be included in the teaching activities.
Instructional Strategies
The family members might be seen as not educated on the matter, so the instructional strategies need to be very efficient. Case studies and tests about the hypertensive crisis and its signs can be used as theoretical background. Moreover, the participants will be asked to conduct interviews with people who have hypertension. The participants should be encouraged to talk about hypertension with other patients, not only the members of their family. Group discussions after the teaching sessions will be arranged.
Time Allocation
Examining the case studies and completing the tests will take an hour and a half. The interviews with patients will not be very long, but the time of these conversations will be determined by the family members. Group discussion will take two hours or more if the participants will show interest in prolonging them.
Instructional Resources
Medical journals, books, case studies, researches, newsreels will be used during this lesson. Internet search and various apps are also recommended to be used because they can bring new relevant information to the participants (Vincent, Abraham, Kochanek, Moore, & Fink, 2011). Medical reports can be helpful too.
Evaluation
To evaluate the participants progress and comprehension of the materials, tests will be offered. Interviews with the medical staff and discussions about the measurement of blood pressure and signs of hypertensive crisis will also be used to evaluate the results.
Staff Development
Lesson Content
Unhindered access to medical care is crucial for any patient, but patients with hypertension often need it as quickly as possible. The staff should determine how to organize or improve the access of the patients to medical care, and outline the improvement plan. Potential risks of hypertension should also be discussed by the staff; lifestyle programs and diets presented to the patients and family members.
Sequence for Teaching Activities
Group discussions of case studies and diet prescriptions will be the first teaching activity. Convincing arguments and their successful presentation will result in progress of the teaching activities (Distler & Philipp, 2013). The second teaching activity will include the developing of a plan of efficient medical care access.
Instructional Strategies
Examples from medical reports, personal experiences of the staff, and case studies will be used. Journals and magazines about healthy lifestyles will be provided to the participants. The staff will thoroughly examine the types of diets and exercises and present them in charts.
Time Allocation
Almost all allocated period will be used by the staff to determine the plan for improvement of the access to medical care and to conduct interviews and organize group discussions for the patients. The staff will be asked to spend at least an hour per week on gaining new information about the diets and physical exercises, as well as finding other relevant materials to the teaching sessions. The remaining time will be used by the staff to analyze the patients interviews with each other and review the results of the surveys on hypertension among patients friends and relatives.
Instructional Resources
Books and articles about hypertension and hypertension crises will be used during the teaching sessions. Interviews with professionals about cardiovascular diseases can also improve the impact of the teaching activities (Schneiderman, Weiss, & Kaufmann, 2013). TV shows about diets and physical activities might also prove beneficial.
Evaluation
After the teaching sessions, the staff will be asked to determine the pros and cons of the lessons. The staff will also be allowed to write down comments and suggestions, as well as new ideas, or to present them with a PowerPoint presentation. Several tests can also be arranged to evaluate the efficiency of the lesson.
References
Distler, A., & Philipp, T. (2013). Hypertension: Mechanisms and management. Berlin, Germany: Springer-Verlag.
Johnson, W., Nguyen, M. L., & Patel, R. (2012). Hypertension crisis in the emergency department. Cardiology clinics, 30(4), 533-543.
Schneiderman, N., Weiss, S. M., & Kaufmann, P. G. (2013). Handbook of research methods in cardiovascular behavioral medicine. Berlin, Germany: Springer Science & Business Media.
Stanley, T., & Moore, B. (2013). Critical thinking and formative assessments: Increasing the rigor in your classroom. London, UK: Routledge.
Vincent, J. L., Abraham, E., Kochanek, P., Moore, F. A., & Fink, M. P. (2011). Textbook of critical care. Amsterdam, Netherlands: Elsevier Health Sciences.
Wilkins, K., Campbell, N. R., Joffres, M. R., McAlister, F. A., Nichol, M., Quach, S., & Tremblay, M. S. (2010). Blood pressure in Canadian adults. Health Reports, 21(1), 37-46.
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