Teaching Nurses to Teach: Peritoneal Dialysis Training

Are cognitive skills taught the same as procedural skills?
Cognitive skills
Cognitive skills can be thought of as information that you want the patient to learn. This information may stand alone on its own, as in recognizing symptoms of peritonitis, or it may be connected with physical skills such as making a sterile connection.
The cognitive lesson begins with the instructor once again stating the purpose of the lesson, how the new idea relates to other information that the patient already knows, and the expected outcome. The body of the lesson involves presenting information that the patient needs in order to perform the intended skill. For example, to recognize the symptoms of peritonitis, patients need information that would help them accomplish this task.

Video: What contributes to a training programs success?Thinking about how to present the new information in a logical and meaningful way can present a challenge to new teachers. Remember to keep information simple and directed to the needs of the patient at that time. For example, you would not want to interrupt a lesson about how perform peritoneal dialysis with a discussion about scheduling supplies. This would distract the patient and decrease the likelihood that either one or both topics would be remembered. However, to increase the understanding of your patient about the peritoneum and the dialysis process, it would be helpful to use an illustration or model so the patient can have a visual reference as you talk about the peritoneal dialysis process.

In the first video, Mary is presenting a lesson using the strategy of questioning. Mary could have simply given the patient information, however by adopting a conversational approach, the patient remains more engaged.

Video: What contributes to a training programs success?Video: What contributes to a training programs success?The next video illustrates the importance of assessing the patient’s comprehension as you present new information. This is very important. If the patient has difficulty recalling information and following a sequence of instructions, then the ability to perform the procedural skills decreases.

Sometimes, you will need to reinforce a cognitive concept taught previously as the patient is learning a procedure. In this video, Mary draws the patient’s attention to the drain bag and stresses the importance that the fluid must be clear and not cloudy. Distinguishing cloudy from clear bags are two concepts that the patient should be taught prior to practicing the procedure. He would have learned this skill by having both cloudy and clear bags available in order to see the difference. This is a good example of how previous learning can be applied at key moments in the training.


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Program Planning
1. Introduction
Lesson Planning
2. Presenting New Information
Procedural Skills
Cognitive Skills
Responding with Feedback & Guidance
Preparing for Training
3. Building in Practice
Lesson Planning - Presenting New Information
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