Page 245 - Nutrition Counseling and Education Skills: A Guide for Professionals

The goal is to assess the level of current knowledge and experience to identify the beginning level of
learning content. For example, an educator counseling a client with long-term diabetes who knows how to
count carbohydrates would begin the learning process at a more advanced level compared with a newly
diagnosed client. It is essential to determine in advance how much the person already knows since it would
waste everyone’s time to repeat known information and could lead to boredom or lack of attention on the part
of the learner.

The basis for educational planning is the preassessment of the client’s or employee’s needs balanced with
what they need to know or do. Preassessment data are often a compilation of multiple sources that may
include activities such as oral interviewing or records review. The initial conversation assesses the learner’s
intellectual and reading skills to understand the instruction.

The line of questioning should be based on what the person needs to know or would like to know. It is
important to ask a variety of questions that address both a learner’s self-evaluation and the educator’s objective
perspective of his or her knowledge.

EXAMPLE “Have you been on a diet before?”
“What foods are good sources of potassium?”
“What is the relationship between your diet and your health?”
“Have you ever used a meat slicer before?”
“Please show me how you set tables at the restaurant where you worked previously.”

Psychological preassessment is also necessary to understand the client’s or employee’s attitudes toward
health and nutrition, willingness to change, motivation, and readiness to learn, which influence his or her
behavior. Attitudes are thought to be predispositions for action and change. Despite our efforts, people often
do not make the changes recommended by health professionals. Problems may not be caused by deficits in
knowledge. Rather, the cause and solution may lie in the affective domain or in the individual’s attitudes,
values, and beliefs.11,12

Eating behaviors are the result of many motivations, and having nutrition information does not necessarily
mean that it will be applied to better food choices. Motivation can enhance learning and behavior change as
well as be a consequence of it. Extrinsic rewards—such as positive reinforcement or praise from peers, a
promotion or salary increase for an employee, or a monetary incentive for participation—can influence
learning. Intrinsic rewards for adults may be a better match to their learning interest. Adults tend to be highly
pragmatic learners who want practical information leading to knowledge or skill about how to do something
that they find important and valuable. The educator must identify the learner’s environment, attitudes, values,
and needs prior to delivering instruction.

For example, the hospitalized patient who has just learned of a confirmed diagnosis of chronic illness is
likely to be more self-focused than knowledge-focused. The patient may be thinking “Why me?” “What did I
do to deserve this?” “How will this affect my job? My lifestyle? My marriage?” The patient is more likely to
have a longer term, rather than an immediate, need for nutrition information. A new employee may feel high
levels of anxiety that may interfere with learning for the first few days on the job. Anxiety may arise whenever
a superior trains a subordinate. “What does the superior think about me?” “I will appear to be dumb if I don’t

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