Bloom’s Taxonomy and Nursing Care

Sherrie Fetterman

Health and Chronic Disease Management/NUR427

October 3, 2011
Gina Stephens

Bloom’s Taxonomy and Nursing Care

An estimated 99 million Americans currently suffer from a form of chronic disease and will enter the health care field unknowing what to expect (Annuals of Internal Medicine, 2011). Disease knows no boundaries nor is there any age limitations. What is consistent, is the disease inflicted patients need to learn about their disease and how to live normal lives regardless of their literary level. In 1956, Benjamin Bloom and a group of educational psychologists developed Bloom’s Taxonomy, a classification of levels of intellectual behavior important in learning. The taxonomy has three domains: the cognitive, affective and psychomotor. Each domain begins with the most basic learning level, and increases to the more intellectual level of learning. As Larsen and Lubkin states, “The teaching-learning process is characterized by multifaceted, dynamic, and interactive exchanges that are fundamental to client-family education and nursing practice” (p. 320). Bloom’s Taxonomy of Education equips nurses with the tools necessary to help patients and family members become successful in coping with their chronic illnesses. The findings of the cognitive domains represent use of knowledge and mental skills of the patient, and is further divided into 6 levels from the lowest level to the highest level of learning, which are: knowledge, comprehension, application, analysis, synthesis, and evaluation. If the patient is on the lowest level, knowledge, the nurse educates by having the patient recall, repeat, recognize, and relate the information. For example, the patient should be able to repeat what the medications are and the side effects. At the highest level, evaluation, the nurse will expect that the patient will be able to assess, predict, support, evaluate, and value the information regarding their chronic illness. An example would be a patient who is at this level of learning would create an exercise program that encourages obtaining goals to better health (Anderson, Krathwohl, Airasian, Druikshank, Mayer, Pintrich, Raths, & Wittrock 2001). The affective domain highlights attitudes and feelings regarding chronic illnesses and how the patient and family members are changing and growing in interest, attitude and values (Lane, 2004). The nurse can gauge how the patient and family members are accepting the disease and coping with the new lifestyle in the affective domain. The different levels are receiving, responding, valuing, organization, and internalizing. The lower level of this domain is receiving. Accepting, acknowledging, and attending to the illness are some characteristics the nurse monitors the patient for ensuring the patient’s ability to advance to the next level of learning. For example, the patient is accepting the disease by showing interest in learning and concerning self with the affects on family members and friends. The higher level in this domain is the internalizing level, and the patient is better able to be consistent in caring for self and making healthy choices according to Anderson et al. (2005). The third domain is the psychomotor and is uses manual or physical skills. The levels in this domain are imitation, manipulation, precision, articulation, and naturalization. The patients are assessed in reference to how the abilities to differentiate by touch, express facially, and perform skillfully (Lane, 2004). At the basic level of imitation the patient can perform behaviors after shown, such as being able to wash hands properly prior to performing a blood stick on the finger. As the patient progresses to the higher level, naturalization, routine becomes a part of daily activities without too much thought. Conclusion It is important that the nurse can determine the most relevant teaching methods that apply to the patient and families situations watching the interactions and evaluating the results of the interventions (Larsen & Lubkin, 2009). Nurses who apply Bloom’s Taxonomy to teach patients and family members with chronic illnesses, recognize how to apply and teach at the level of learning acceptable thus improving their quality of life.

References
Anderson, L.W., Krathwohl, D.R., Airasian, P.W., Druikshank, K.A., Mayer, R.E., Pintrich, P., Raths, J. & Wittrock, M., (2001). A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom’s Taxonomy of Educational Objectives. New York: Addison Wesley Longman.
Annuals of Internal Medicine. (2011). Chronic illness management: What is the role of primary care? Retrieved from http://www.annals.org/content/138/3/256.short
Lane, C. (2004). Bloom’s Taxonomy. Retrieved from http://jove.geol.niu.edu/faculty/kitts/GEOL401/Bloom’s%20Taxonomy.pdf
Larsen, P.D. & Lubkin, I.M. (2009). Chronic illness: Impact and intervention (7th ed.). Sudbury, MA: Jones and Barlett.