NAME: _____________________________
Date: ________
TEACHING PLAN: Individual Patient
Patient Learning
Outcomes
Identify one or two
outcomes to be
achieved as a result of
attending this teaching
session.
Methods
List the teaching
modalities that will be
utilized during the
teaching session.
Teaching Tool: Explain
what type of tool will be
used.
Readiness to Learn: Yes
□
No
Content Outline
Evaluation
Outline the content material that will be
presented. The outline should be in a
logical and sequential order which list
the detailed information to be covered
during the teaching session.
List the evaluation methods that
will be used.
Patient Response: Document
the patient’s response following
the session to evaluate the
teaching effectiveness and need
for reinforcement.
□
Identified Barriers to Learning:
Communication difficulties, physical impairment, cognitive impairment, sensory impairment,
cultural barriers, emotional barrier, religious barrier, language, lack of motivation/readiness.
Explain _____________________________________________________________________