Department of Nursing
Texas A&M University, Corpus Christi, Texas
Application of Learning Theory
Among the many complications that can occur with pregnancy, one of the most prevalent and potentially life threatening for mother and fetus is gestational diabetes. Unfortunately, the possibility for the mother to eventually become a Type 2 diabetic is significantly higher if she was previously diagnosed with gestational diabetes. According to the National Institute of Health: * Reported rates of gestational diabetes range from 2 to 10 percent of pregnancies. * Immediately after pregnancy, 5 to 10 percent of women with gestational diabetes are found to have diabetes, usually type 2. * Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes in the next 10–20 years. * New diagnostic criteria for gestational diabetes will increase the proportion of women diagnosed with gestational diabetes. Using these new diagnostic criteria, an international, multicenter study of gestational diabetes found that 18 percent of the pregnancies were affected by gestational diabetes (National Diabetes Clearinghouse, 2011).
The following teaching plan will help the gestational diabetic to successfully manage her illness during pregnancy, using guidance in glucose testing, menu planning, medication management, and follow-up teaching post partum to help reduce her chances of becoming a Type 1 or Type 2 diabetic. TARGET POPULATION
Because gestational diabetes is associated with pregnancy, the target population is young females of child-bearing years. The specific focus will be on those who live in an underserved area of the city and who tend to be on Medicaid due to lack of private insurance. Most of these females have minimal education and resources to adequately care for their illness. Another factor that may be considered is ethnicity in relation to prevalence of cases. For example, Hispanic and African American women have a higher rate of gestational diabetes as well as development of Type 2 diabetes post partum (Dabelea, Snell-Bergeon, Hartsfield, Bischoff, Hamman, McDuffie, 2005). Many in this underserved group do not receive the appropriate teaching in management of the disease and instruction on preventative measures with subsequent pregnancies. TEACHING/LEARNING THEORY
The goal is to develop a teaching plan, using primarily the behaviorist learning theory based on the idea that this theory focuses “mainly on what is directly observable, [and] view learning as the product of the stimulus conditions (S) and the responses (R) that follow” (Bastable, 2010, p. 54). While the main materials used for teaching will remain the same, the plan can be tailored to suit each learner based on her responses to what she is being taught. By providing positive feedback for a successful response and, thus, motivating the learner to learn, “giving positive reinforcement (i.e., reward) greatly enhances the likelihood that a response will be repeated in similar circumstances” (Bastable, 2010, p. 57). Therefore, putting into place observable, positive results for appropriate choices can reinforce the patient’s ability to continue to practice better decisions and habits outside of the clinical setting. LEARNING OBJECTIVES
1. Patient and significant other and/or family will understand the fundamentals of gestational diabetes, how it occurs, and what possible risks are associated for mother and baby, as well as signs and symptoms of hypo and hyperglycemia. Teaching strategy will include written materials and discussion and positive feedback for appropriate responses. 2. Patient and significant other/family will understand how to use the glucometer to check her glucose levels throughout the day and instructed on normal versus abnormal readings. Teaching strategy will be to lead her step by step in the use of the glucometer...