VIOLET TEAM

B. PERSPECTIVE ON TEACHING AND LEARNING (cont.)

Assessment and Evaluation

A. Learning Assessment of Clients

Patient Assessment Skills
➢ Standard I Assessment
In an assessment the nurse must use all his or her senses. These include hearing, touching, visual,
and therapeutic communication. The cephalocaudal approach is most always used. In other words,
assessing a patient from head to toe. The nurse must be self-aware to be able to conduct a thorough
assessment. Data collection forms the basis for the next step in standards of care which is diagnosis.
➢ Standard II Diagnosis
A nursing diagnosis is a formal statement that relates to how a client reacts to a real or perceived
illness. In making a diagnosis the nurse attempts to formulate steps to assist the client in alleviating
and or mediating how they respond to real or perceived illness.
➢ Standard III Outcome Identification
In this process the nurses use the assessment and diagnosis to set goals for the patient to achieve
to attain a greater level of wellness. Such goals may simply be that the patient now comprehends
the regime of testing their blood sugar, or perhaps a new mother gleans a sense of security now
that she has been instructed in the correct method of breast feeding.
➢ Standard IV Planning
The planning standard is designed around the client’s activities while in the hospital environment.
Therefore, the nurse must plan to teach and demonstrate tasks when the patient is free to learn
➢ Standard V Implementation
This standard requires that the nurse put to the test the methods and steps designed to help the
client achieve their goals. In implementation, the nurse performs the actions necessary for the
client’s plan. If teaching is one of the goals, then the nurse would document the time, place,
method, and information taught.
➢ Standard VI Evaluation
Evaluation is the final standard. In this step the nurse makes the determination whether the goals
originally set for the client have been met. If the nurse conclude that the goal or goals have not
been met, then the plan must be revised.
 B. Methods of Evaluation

What is EVALUATION?
Definition: Evaluation is a process that critically examines a program. It involves
collecting and analyzing information about a program’s activities, characteristics, and
outcomes.
Importance: Evaluation provides a systematic method to study a program, practice,
intervention, or initiative to understand how well it achieves its goals. Evaluations help
determine what works well and what could be improved in a program or initiative.
Purpose: Evaluation makes judgements about a program, to improve its effectiveness,
and/or to inform programming decisions (Patton, 1987).

Evaluation of Health Education Program:

There should be continuous evaluation
• Evaluation should not be left to the end but should be done from time to time for purpose
of making modifications to achieve better results.

1. Questionnaires.
- A questionnaire is a specific set of written questions which aims to extract specific
information from the chosen respondents. The questions and answers are designed in order
to gather information about attitudes, preferences, and factual information of respondents.
- Questionnaires are simple and effective tools for collecting information from a large
number of people. Compared with other ways of collecting information, questionnaires are
relatively inexpensive to administer. They can be used to gather information about the
community-building process itself (process evaluation) or the results it produced (outcome
evaluation).
Example: A survey on qualitative research

2. Focus Group
-- A focus group brings together a group of participants to answer questions on a topic of
interest in a moderated setting. Focus groups are qualitative in nature and often study the
group’s dynamic and body language in addition to their answers. Responses can guide
future research on consumer products and services, human behavior, or controversial
topics.
- Group interviews are another way to collect information from many people. Most people
are familiar with focus groups. A focus group is a small group gathering conducted
specifically to collect information from the group members. During a focus group
discussion, between 6 and 12 people, who re similar in one or more ways, are guided
through a facilitated discussion on clearly defined topic (Krueger and Casey, 2000).
Example: A parents of a preschoolers meets to discuss childcare needs. Parents share their
views on local childcare programs, and on what could be done to improve them.

3. Interviewing
- An interview is a qualitative research method that relies on asking questions in order
to collect data. Interviews involve two or more people, one of whom is the interviewer
asking the questions.
 - Interviews should be structured, yet conversational. Begin by making the key informant
comfortable. Maintain a neutral attitude throughout the interview. Don’t try to defend your
community-building project questions or argue with the key informant’s assessment of a
situation. Be prepared to probe or use follow-up questions to gather additional information
that might clarify why the key informant sees the situation as he or she does. Be sure to
take detailed notes-they are essential to accurate analysis.
Example: Live interviews (one-on-one and a panel type), Phone interviews (one-on-one
and a panel type), Video or Skype interviews, and Taped interviews.

4. Observation
- The observation method is described as a method to observe and describe the behavior of
a subject. As the name suggests, it is a way of collecting relevant information and data by
observing.
- The aim of observation is to document behavior through watching and listening. Through
observation it is possible to see what people are doing, when they do it, where they do it,
and how they are doing it. You can use observation to gather information about the
community-building process itself (i.e., process evaluation) or the results it produced (i.e.,
outcome evaluation).
Example: A researcher can use the observation method in a Montessori school and record
the behavior of the children at a young age. Are the children comfortable sharing their tiffin
at such an early age will make a good study for the researcher? In this example, the
researcher can observe and record the details objectively. Observation data collection
method is associated with a few ethical issues as it needs the full consent of a research
participant.

C. Qualities of Good Measurement

A test’s usefulness, according to Bachman and Palmer (2000), can be determined by
considering the following measurements qualities of the test: reliability, construct validity,
authenticity, interactivity, impact, and practicality. These qualities can easily describe a good
language test’s usefulness.
1. Test Reliability
The term reliability refers to consistency of measurement. Elaborately, they go on
to say that a reliable test score is consistent across different characteristics of the testing
situation. Moreover, if test scores are inconsistent, they provide no information about the
ability being measured.
2. Construct Validity
The test’s reliability and validity are strongly correlated. Any valid test is
considered a reliable test; however, not all reliable tests can be considered valid (Alderson,
2000). Recently, according to Alderson (2000), “the term construct validity is used to refer
to the general, overarching notion of validity”. Therefore, the main focus of discussing the
test’s validity is construct validity, in addition to some issues regarding this test’s content
validity.
 According to Bachman and Palmer (2000), the term construct validity refers to the
extent to which people can interpret a given test score as an indicator of the abilities or
constructs that people want to measure. However, no test is entirely valid because
validation is an ongoing process (Weir, 2005).
3. Authenticity

Bachman (1991) defines authenticity as the appropriateness of a language user’s

response to language as communication. However, this definition was too general.
Therefore, Bachman and Palmer (2000) divided this idea into two parts. The first relates
to the target language’s use, which they refer to as authenticity; and they define the second
according to its relation to the learners involved in the test. Below is a detailed explanation
of authenticity and its implications for the current test. Authenticity relates a test’s task to
the domain of generalization to which we want our scores’ interpretations to be
generalized. It potentially affects test takers’ perceptions of the test and their performance
(Bachmann, 2000).

4. Interactiveness

Interactiveness, according to Bachman and Palmer (2000), is “the extent and type
of involvement of the test taker’s individual characteristics in accomplishing a test task”.
Does the test motivate students? is the language used in the test’s questions and
instructions appropriate for the students’ level? Do the test’s items represent the language
used in the classroom, as well as the target language? All these questions represent the
crucial elements that affect a test’s interactiveness. Many recent views consider this notion
the core of language teaching and learning.
5. Impact

According to Bachman and Palmer (2000), impact can be defined broadly in terms
of the various ways a test’s use affects society, an educational system, and the individuals
within them. In general terms, a test operates at the macro level of a societal educational
system while corresponding to individuals, i.e., test takers, at the micro level. According
to the test’s developer, society, educational systems, and the individuals correlate strongly
to this test.

6. Practicality

“Practicality is the relationship between the resources that will be required in

design, development, and use of the test and the resources that will be available for these
activities” (Bachman and Palmer, 2000). They illustrated that this quality is unlike the
others because it focuses on how the test is conducted. Moreover, they classified the
addressed resources into three types: human resources, material resources, and time.
 Based on this definition, practicality can be measured by the availability of the
resources required to develop and conduct the test. Therefore, our judgement of the
language test is whether it is practical or impractical.

D. Interaction Process Analysis/Process Recording

The interaction process analysis (IPA) is an instrument developed in the middle of the 20th
century by Robert Freed Bales for the observation of interaction processes in small social groups.
Interaction process analysis is a technique for recording and analyzing the interactions between
people in a face-to-face group
The Process Recording
The nurse analyzes what is said (the content of the interaction) and the flow of the
interaction (the process). This analysis augments the nurse's ability to increase awareness of
feelings, values, expectation and assumptions.
Process recordings allow student to:
• enhance their ability to attend to a conversation with a client and remember it without
relying on recording devices.

• converge listening skills and self-awareness

• review the conversation in detail and therefore possibly identify patterns.

• to write clearly and coherently about the complex thoughts, actions, and feelings that
comprise their service practice.

• reflect on their work, integrating theoretical concepts, skills, and values that are being
taught in the curriculum.
How to write an Interaction Process Analysis/Process Recording
Record:
1. IDENTIFICATION DATA
✓ Name:
✓ Age:
✓ Sex:
✓ Address:
✓ Religion:
✓ Date of Admission:
✓ Date of Discharge:
✓ Mrd No:
✓ Occupation:
✓ Attending Doctor:
 2. PRESENTING COMPLAINTS ACCORDING TO PATIENT
3. ACCORDING TO RELATIVE WHAT ARE ALL THE CHIEF COMPLAINTS
4. AIMS & OBJECTIVE OF INTERVIEW:
• FOR PATIENT
• FOR STUDENT NURSE
Example:
For Patient
1. It helps to know about patient’s condition
2. It helps the patient to get socialize.
3. It provides information about diagnosis.

For Student Nurse

1. It helps to obtain cooperation & confidence from patient.
2. It helps to develop therapeutic relationship with client.
3. It helps to understand patient psychological behavior, problems, signs,
and symptoms

5. CONTENT

Interviewer: Student Interviewee: Patient Therapeutic Evaluation / Analysis

Nurse (Verbal and (Verbal and non- communication of Interaction
non-verbal) verbal) techniques

6. EVALUATION/CONCLUSION/SUMMARY
Example:
INTERACTION PROCESS ANALYSIS (IPA)
Student’s Name: Marisa DeLuca
Client’s Name: Mrs. M
Interview Date: 3/1/2018

I. PURPOSE OF THE SESSION: List three goals for your patient for the day of the IPA.

1. Patient will answer all questions honestly

2. Patient will respect myself and my other interviewers during the session
3. Patient will open up about his feelings
II. EXPECTATIONS OF THE SESSION: List three goals for yourself during this interaction.

1. To establish rapport in a comfortable setting

2. To respect the client and be unbiased
3. To communicate effectively with therapeutic communication skills

Observation of Setting Analysis and Recommendations

(Identify what facilitated the exchange, what were
barriers, and positive and negative aspects of the
exchange)
The student had introduced herself and Facilitators:
stated the purpose of the interview to the ⚫ Introduced self the night before and stated
patient the evening prior to this process purpose.
recording. ⚫ Curtains drawn between beds
⚫ Client relaxed and verbalized excitement about
talking with student

This communication exchange took place ⚫ Turned TV off

at about 9 o‘clock in the morning. The ⚫ Room had personal touches
patient, Mrs. M., was in a semi-private
room in bed number one which is the bed
closest to the door.
As a consequence, the room was quite Barriers:
noisy during the exchange since there ⚫ Semi-private room with roommate present
were other health care workers coming in ⚫ Room entered by care providers for bed 2
and out of the room to attend to the other ⚫ Noisy and cramped space
patient. The curtain was drawn between ⚫ Door open—Mrs. M. looking for visitors could
the beds to minimize the noise. Mrs. M., prevent her full participation in interaction
however, requested that the door be left
open in case someone wanted to come in
and visit. Mrs. M. appeared rather relaxed
and verbalized that she was excited to be
able to talk with a nursing student. The
television was on when the student
entered the room but was turned off, with
permission, before the process recording
began. The room itself was rather
cluttered and cramped making it difficult
for the student to maneuver in the room.
Mrs. M. also had balloons, flowers, and
cards that added to the overall
atmosphere of the room. Those items
made the hospital room look warmer and
more comfortable.
 Interviewer: Interviewee: (Mrs. Identify Analysis of Interaction
(Student) M.) Communication
Technique (Was technique effective, why
or why not? Was there
anything else that could have
been explored?)
“Good morning “Sure, come on in. Providing Telling Mrs. M. what she was
Mrs. M. We‘re You can just go Information doing would put her at ease
going to go ahead ahead and do and make her feel safe and
and start the short anything you want, secure.
interview that we honey.”
talked about (smiling)
yesterday, if that‘s
okay with you.”
(using direct eye
contact and a
friendly tone of
voice)
Student pulls up a Student positioned ⚫ Enhances trust
chair and sits near herself for active ⚫ Facilitates communication
the head of the bed listening (SOLER) ⚫ Conveys interest and
(at patient‘s eye involvement
level) ⚫ Eye contact conveys
sincerity, interest, and
professionalism
“Well, let‘s go
ahead and get
started.” (using
direct eye contact).

“Why don‘t you “Well (Mrs. M. ⚫ To seek information

tell me how you sighs) I have mixed ⚫ To allow client to take the
feel about going feelings you see lead in the conversation
home today?” because I really and give pertinent
would like to get Asking relevant information
home so I can work questions
on my geneology
records I‘ve been
“Um-huh. doing. But (pauses)
(nodding head, I don‘t want to go
using good home until I‘m
posture) completely better.
 You see, I was in
here before and I
Student continues got this disease ⚫ Using positive non- verbal
to nod from the lady I was messages lets client know
intermittently as sharing the room Continued use of student is interested
well as saying with. I just know I active listening ⚫ Use of paraphrasing or
“um- huh” or “yes” got it from sitting in clarifying may have been
the same armchair helpful here
as her. Then, (sighs
and frowns), when I
got home I was
sick. I started
coughing and
vomiting. I ended
up right back here
again (puts
emphasis on again).
“So, you really “I (um) Oh, I don‘t Reflecting and ⚫ Trying to keep
aren‘t sure you know. (puzzled Focusing conversation focused
want to go home tone of voice and ⚫ May have needed to use a
yet.” puzzled look on close-ended question here
face) You see my to zero in on only one area.
daughter, she lives
in Springfield, and
takes care of my
husband who has
Alzheimer‘s
Disease.
She thinks that I
ought to stay in
here for a while
longer to be sure I
am better before I ⚫ Trying to keep
go home. She takes conversation on track
care of my husband ⚫ An effective way to get
in a home, you more information but
know, so she knows sometimes you get more
a lot about hospitals information than you need
and stuff like that. ⚫ Focusing could have been
helpful here
⚫ Would be interesting to
know what prompted this
“Mary?” (Mrs. M. question. If wanting to
“Has your daughter pauses) No. But I know why daughter
been in to visit you have one son and wanted her to remain in
since you‘ve been three daughters you the hospital, a more direct
in the hospital?” know. They ‘re question may have worked
spread out all Probing better.
across the United
States. My son just
got out of the
hospital with some
prostate problems
so he couldn‘t be
here. He‘s a lawyer
too so he‘s very
busy. And then
there are the twins
(chuckling). Well,
they aren‘t really
twins. They are 9
years apart but they
look just alike.”

“My son called me ⚫ Conversation was

this morning. He is (Interpreting becoming idle, needed to
doing pretty good. Information and ask something like “How
He just got attempting do you plan to manage
discharged refocusing was intent when you go home?” or
yesterday. But my of the student) asking about the neighbor
neighbor came to could be used to focus the
see me yesterday.” conversation.

“I see you‘ve
gotten balloons and
flowers all over Changing the subject
there. But no one
has been in to
visit?”
“Well good. It “Oh yes. And I am Summarizing ⚫ Used to let Mrs. M. know
sounds like you‘ve so glad. It is boring the conversation was near
been keeping in here, you know.” the end.
pretty busy in here, ⚫ Did not really summarize
then.” key points
⚫ Brought closure but was
somewhat abrupt.
“Well my time is “Oh you‘re
up. Thank you for welcome honey.
allowing me to talk (smiles) Terminating
with you. (Direct Always glad to help interaction
eye contact) I hope a student. I hope I
all goes well for won‘t have to come
you at home.” back here for a long
time.”

EVALUATION
(What is your overall impression of this communication exchange? Was the goal of the interview
achieved? Were there any recurring themes in the exchange? What were the interviewers strengths
or weaknesses? What was the social value of this exchange?)
This process recording conveyed that the student was comfortable talking with Mrs. M. It did convey
some difficulty staying focused on the particular issue of concern. Mrs. M. shared a lot of information
that was not really relevant to what the student wanted to know. Being comfortable and proficient
with the use of paraphrasing, clarifying, and focusing may have helped the student gather the
pertinent data needed with the client getting off the subject. Active and attentive listening can give
cues to what is really important to a client. In this interaction the client‘s family was very important
to her.

All in all the interaction was therapeutic, although the primary objective of finding out how she felt
about going home was never really met. Follow-up questions were needed to guide the conversation
back to that focus and get the information that was sought. The social interaction would have been
beneficial to the client regardless of whether the main objective was realized or not.

My goals for further communication growth would be:

1. Learn to use additional techniques such as paraphrasing, clarifying, and focusing redirect
conversation so I can achieve the intended information.
2. Learn to use a variety of techniques naturally without having to think about them.

"The most important practical lesson that can be given to nurses is to teach them what to
observe. “
Florence Nightingale
References:
https://www.betterevaluation.org/en/evaluation-
options/questionnaire#:~:text=A%20questionnaire%20is%20a%20specific,and%20factual%20in
formation%20of%20respondents.

https://www.scribbr.com/methodology/interviews-research/

https://www.marketing91.com/observation-
method/#:~:text=The%20observation%20method%20is%20described,information%20and%20d
ata%20by%20observing

PREPARED BY:
Sansarona, Ari-ane
Sansarona, Hania Nadra
Sarip, Norfrida
Taher, Farah Fameda
Usman, Julysa Aliah