Learning occurs in three domains: cognitive, affective, and psychomotor. When developing a teaching plan for the patient, the nurse must consider each domain.
The cognitive domain refers to intellectual activities such as thought, recall, decision making, and drawing conclusions. In this domain the patient uses previous experiences, prior knowledge, and perceptions to give meaning to new information or to modify previous thinking. The nurse makes use of the patient’s cognitive abilities when information is given to the patient or caregivers about the disease process, medication regimen, and adverse reactions. The patient uses the cognitive domain to process the information, ask questions, and make decisions.
The affective domain includes the patient/caregiver’s attitudes, feelings, beliefs, and opinions. Health care
providers often ignore these aspects of patient teaching. It is easy to pull a preprinted teaching outline off of the computer or obtain preprinted material. This type of material is often used as a checklist to teach the patient about a drug and the therapeutic regimen. Such checklists are useful in helping the nurse remember important aspects of the drug that should be covered when teaching the patients about the drug and to give to the patient for future reference. However, the use of such checklists fails to take into account the affective
Perhaps the most important prerequisite to learning about the patient’s affective behavior is to develop a therapeutic relationship with the patient (one that is based on trust and caring). When the nurse takes the time to develop a therapeutic relationship, the patient/family has confidence in the nurse and more confidence in the information to be taught. The nurse approaches the patient with respect and encourages the expression of thoughts and feelings. Exploring the patient’s beliefs about health and illness enhances the nurse’s understanding of the patient’s affective behavior.
The psychomotor domain involves learning physical skills (such as injection of insulin) or tasks (such as performing a dressing change). The nurse teaches a task or skill using a step-by-step method. The patient is allowed hands-on practice under the supervision of the nurse. The nurse assesses the patient mastery of the skill by having the patient or caregiver perform a return demonstration under the watchful eye of the nurse.
source: Introductory clinical pharmacology