One To One Instructions In Nursing What Are One-to-One Instructions?

One-to-one instruction refers to the direct, face-to-face delivery of educational information tailored to meet the needs of an individual learner. This teaching method can be formal or informal. Formal one-to-one instruction is planned and structured, while informal one-to-one teaching takes advantage of teachable moments that arise unexpectedly when the learner shows readiness. For instance, a nurse might use an informal approach to teach a patient who demonstrates interest in understanding their medication during a routine hospital visit (Miller & Stoeckel, 2016).

This method is characterized by mutual communication between the educator and the learner, with knowledge exchanged primarily through oral communication, although non-verbal cues are also significant. One-to-one instruction requires strong interpersonal skills, sensitivity, and the ability to build rapport between the educator and the learner (Falvo, 2010; Gleasman De Simone, 2012).

Pros and Cons of One-to-One Instruction Methods in Healthcare and Nursing Education

One-to-one instruction, when effectively employed, can significantly impact patient education and compliance (Martin et al., 2005). However, there are both benefits and challenges to this method:

Pros:

• Personalization: One-to-one instruction allows educators to tailor content to the specific needs and learning styles of the individual, making the learning more relevant and accessible.
• Enhanced Retention: By presenting information in smaller, bite-sized portions over sessions that last no more than 15 to 20 minutes, learners can process the material better. Research shows that presenting too much information at once leads to poor recall (Martin et al., 2005; Kessels, 2003).
• Targeted Feedback: Direct, immediate feedback is possible, which helps the learner correct misunderstandings and reinforces the correct behaviors or knowledge.
• Flexibility: Teaching can occur when the learner is ready, taking advantage of real-time opportunities, such as when a patient shows interest or asks questions.

Cons:

• Time-Consuming: One-to-one instruction can be labor-intensive and costly, particularly in clinical settings where resources like staffing and time are constrained.
• Limited Reach: While effective for individual learning, this method only benefits one person at a time, making it less efficient in terms of resource allocation for larger groups or organizations.
• Risk of Information Overload: Learners may become overwhelmed if too much information is provided at once, especially if the content is complex. Thus, information should be offered in manageable segments, with ongoing evaluations to ensure understanding.

One-to-one instruction should actively engage the learner rather than resemble a lecture aimed at an audience of one. The session must focus on the learner’s unique needs, with specific, personalized objectives set by both the educator and the learner (Burkhart, 2008).

Interactions and Stages in One-to-One Instruction

The stages of behavior change are crucial in structuring one-to-one instructional interactions, particularly in healthcare education. The Stages of Change model (Prochaska et al., 1994) provides a framework to guide interactions:

1. Precontemplation Stage: The educator provides non-threatening information to raise awareness of the learner’s negative behaviors or risks.
2. Contemplation Stage: The educator supports decision-making by helping the learner weigh the benefits of change against the barriers.
3. Preparation Stage: Educators help learners create realistic, small, and measurable goals, offering strategies for success and positive reinforcement.
4. Action Stage: Learners are encouraged to practice the new behavior consistently. Educators provide feedback, rewards, and strategies to monitor and evaluate progress.
5. Maintenance Stage: Continued support is provided to consolidate new behaviors and prevent relapse.

In a clinical setting, an educator might work with a patient managing obesity by helping them assess weight control options, setting mutual goals, and regularly evaluating their confidence and progress. Goal-setting and contracting are essential components that clearly define the roles and expectations of both the learner and educator. Written contracts with specific objectives agreed upon by both parties can significantly enhance learning outcomes.

Problems With One-to-One Instruction Questions

Effective questioning is critical to engaging the learner, but it can pose challenges. Two common problems arise in this context:

1. Unclear Questions: When the educator asks questions that are vague or poorly structured, the learner may become confused about what is being asked.
2. Overloaded Questions: Questions that contain too many facts or concepts at once may overwhelm the learner, making it difficult to process and respond effectively (House, Chassie, & Spohn, 1990).

To mitigate these issues, educators should observe the learner’s non-verbal cues and adjust their questioning approach when confusion is evident. Additionally, giving learners time to process information and encouraging thoughtful responses enhances the effectiveness of questioning as a teaching strategy. Interrupting learners before they have finished answering can create frustration and impede learning.

The Teach-Back Method

One of the most effective strategies in one-to-one instruction is the teach-back or tell-back method. This technique involves asking learners to restate or demonstrate what they have understood in their own words. It ensures the learner has accurately grasped the material and allows the educator to assess comprehension. Simply asking “Do you understand?” is inadequate, as research indicates that only about 50% of what is taught is retained, and even less is correctly recalled (Kessels, 2003). Using open-ended questions and encouraging learners to actively summarize their learning ensures that knowledge has been transferred correctly.

One-to-One Instruction in Clinical Teaching

In nursing education, one-to-one instruction is often employed in clinical settings, such as skills laboratories or real-world clinical environments. The educator may use a variety of teaching methods—role-playing, demonstrations, and return demonstrations—to reinforce learning. In these situations, specific, individualized objectives are set to meet the learner’s unique needs (Emerson, 2007; Gaberson, Oermann, & Shellenbarger, 2013).

Preceptors, who are experienced clinicians guiding less experienced staff or students, often use one-to-one instruction. However, preceptors may not always be skilled educators, and thus require training on how to effectively teach and mentor others. Workshops and coaching can support preceptors in this role, enhancing their ability to educate and guide learners effectively.

Economic Considerations in One-to-One Instruction

While one-to-one instruction is effective for personalized learning, it is also resource-intensive. It may not be economically feasible in all situations, particularly in healthcare organizations where cost control is essential. Clinical teaching and staff education are vital but can be costly when delivered individually. As healthcare institutions face tight budgets and high staff turnover, the expense of one-to-one orientation for new staff or ongoing education may become prohibitive (Del Bueno et al., 1990).

Conclusion

One-to-one instruction is a valuable teaching method in nursing education, offering personalized learning experiences that can significantly improve patient education, staff development, and student learning. While it requires time and resources, the benefits of tailored, interactive teaching often outweigh the challenges. Educators must balance the economic costs with the benefits of individualized instruction and use strategies like the teach-back method to ensure the effectiveness of learning. By assessing the learner’s progress and adapting the approach as necessary, one-to-one instruction can be a powerful tool in fostering deep understanding and long-term behavioral change in nursing and healthcare settings.