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TRATEGIES FOR SUCCESSFUL NUTRITION COUNSELING
argeting Your Patient’s Preferredearning Style
onna Morton de Souza, MPH, RDR
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DENTIFICATION OF AN individual’s pre-ferred way of learning can assist professionals
n choosing specific education methods to besteet the patient’s needs.
What Are Learning Styles?Learning styles are different approaches to or
referred ways of learning. Individuals are eitheright- or left-brain dominant and may preferisual, auditory, or tactile approaches to learning.
Right-Brain or Left-BrainDominant
Both sides of the brain can reason, but byifferent strategies, and one side may be domi-ant. The left brain is considered analytic inpproach, whereas the right is described as holis-ic or global. A left-brain-dominant individualikes things done in a step-by-step sequentialormat, beginning with details leading to a con-eptual understanding of a skill, whereas a right-rain-dominant person prefers to learn beginningith the general concept and then going on to
pecifics.1
eft-Brain Dominant
● Prefer well-structured assignments● Sequential● Plans ahead● Responds to word meaning● Attentive during long verbal explanations● Responds to logic
Professional Nutrition Services, Inc, Pembroke Pines, FL.Address reprint requests to Donna Morton de Souza, Professionalutrition Services, Inc, PO Box 823033, Pembroke Pines, FL3082. E-mail: [email protected]
© 2006 by the National Kidney Foundation, Inc.1051-2276/06/1601-0012$32.00/0
hdoi:10.1053/j.jrn.2005.10.012
ournal of Renal Nutrition, Vol 16, No 1 ( January), 2006: pp 75-78
● Recalls people’s names● Prefers individual counseling● Speaks with few gestures● Punctual
ight-Brain Dominant● Prefers visual instructions with examples● Random● Impulsive● Responds to tone of voice● Becomes restless during long verbal explana-
tions● Responds to emotion● Recalls people’s faces● Prefers groups● Gestures when speaking● Less punctual
Do You Know Your PreferredLearning Style?
Several websites include simple exercises toetermine your dominant style of learning. It ismportant to understand what your learning styles because educators tend to teach using theirreferred learning style. If you are left-brain dom-nant, your tendency to go step-by-step may feelery laborious and boring to the right-brainederson. They may dislike lists and steps and thriven making intuitive connections. If you are aight-brain-dominant educator, you may seem toe very disorganized to the left-brained person. Ifhere is a major mismatch in learning styles, theearner may “tune out” and not hear or under-tand you. If this seems to be occurring, trydapting your educational approach or try an-ther educator.For example, if you are a left-brain-dominant
ducator, you may approach your patient with atep-by-step explanation of the consequences of
igh serum phosphorus levels. You begin your75
DONNA MORTON DE SOUZA76
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PATIENT EDUCATION 77
nstruction by explaining how as kidney functionecreases, phosphorus retention occurs. You re-iew the recommended laboratory values forhosphorus and describe possible consequencesf high serum levels, including itchy skin, redyes, and calcification of soft tissue. You thenegin to state which foods are high in phosphorusnd suggest alternative choices.
You observe your patient looking frequently athe television, making jokes, and fidgeting in hishair. He gives you a blank stare when you quizim about foods high in phosphorus that you justentioned. You may feel a bit frustrated as you
ealize your patient may not have been listeningo you. You then decide to show him someolorful pictures of foods and beverages and askim to point to those he likes. You find that he isow eagerly participating.As he verbalizes his food preferences, you
how enthusiasm when he indicates low phos-horus choices. He is given a colorful hand-outo take home that illustrates alternative choicesor high-phosphorus foods and beverages. Addi-ionally, you show him photos of red eyes, cal-ium phosphate crystals on skin or calciphylaxis,tc, to emphasize the consequences of high serumhosphorus levels. To emphasize how phosphateinders work, you may decide to conduct asponge demonstration.” The patient is asked toctively participate by placing the sponges in theiquid.
If there still seems to be a disconnect with thisatient, ask another educator to speak with him.his does not mean failure on anyone’s part.nother person might just be a better “learning
tyle match.”In addition to determining whether your pa-
ient is left- or right-brain dominant, try to iden-ify whether the learning preference is visual,uditory, or tactile.
Visual LearnersVisual learners learn best by seeing. They need
o see the educator’s body language and facialxpressions to fully understand the content of aesson. They may think in pictures and learn bestrom visual displays. During a lecture, visualearners often prefer to take detailed notes tobsorb the information. They prefer sitting at the
ront of a classroom to avoid visual obstructions. hListen for visual clues during conversations.isual learners may use words such as look, see,
how, hazy, dull, foggy, bright, picture, vague.xamples include:
I’m a little foggy about what you mean.”I see the big picture now.”Can you write that down for me?”
Visual Learning ApproachesFor visual learners, use approaches such as bulle-
in board displays, hand-outs, flipcharts, photos,ood and beverage containers, measuring cups andpoons, restaurant menus, recipes, laboratory reportards, videos, flash cards, newsletters, visual games,emonstrations, etc.
Auditory LearnersAuditory learners learn best by listening and
hrough verbal discussions. They like talkinghings through and listening to what others haveo say. Auditory learners interpret the underlyingeanings of speech through listening to tone of
oice, pitch, speed, etc. Written information mayave little meaning until it is heard. These learn-rs often benefit from reading text aloud andsing a tape recorder.Listen for clues such as hear, tell, sounds, say,
isten, talk, ring, noisy, tone. Examples include:
That sounds great.”I hear what you’re saying.”Tell me what you want me to do.”
Auditory Learning ApproachesFor auditory learners, use approaches such as
eading hand-outs and report cards out loud toour patients; recommending that patients attendupport group meetings; recording a short lessonn a cassette or CD for patients to listen to duringreatments; providing educational videos, verbaluizzes, or games; and role playing with two orore patients.
Tactile or Kinesthetic LearnersTactile or kinesthetic individuals learn best
hrough moving, doing, and touching. They pre-er a hands-on approach, actively exploring thehysical world around them. They may find it
ard to sit still for long periods and may become
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DONNA MORTON DE SOUZA78
istracted by their need for activity and explora-ion. Tactile clues may include words like feel,hape, warm, cold, vibes, rough, grasp, smooth.xamples include:
I’m not quite grasping what you’re saying.”I’ve got a rough idea how it works.”Let me try it out.”
Tactile Learning ApproachesFor tactile learners, use approaches such as
ands-on activities with food models, medica-ions, or other items; participation in demonstra-ions; taste tests; role play with props such asenus; supermarket tours; holding saline bags to
emonstrate fluid weight gains; educational bingoames, crossword puzzles, word search, mazes;
agnet or flannel board games; etc. 1An optimal educational approach would be tottempt to target visual, auditory, and tactile learn-ng styles all at the same time. Some examplesnclude:
● Hands-on education or guessing games withfood models or other items
● Written question inside a plastic egg activity● Sponge demonstration (how phosphate bind-
ers work)● Role playing with restaurant menus
Reference1. Knowles MS, Holton FE, Swanson AR: The Adult
earner, The Definitive Classic in Adult Education and Humanesource Development. Houston, TX, Gulf Publishing Co,
998
