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Nursing Practice I — Community Health Nursing
문제

Situation: The nurse holds health teaching sessions at a barangay senior citizens' center. Several participants have hearing or vision problems, and one woman from an indigenous community speaks only her own language. Which assumption of adult learning (andragogy) should guide the nurse in planning these sessions?

해설
Knowles described adults as self-directed learners who bring rich experience, want learning that solves current problems, and are motivated from within. Teacher-controlled, subject-centered learning for later use describes traditional pedagogy, and reliance on external rewards is not the core adult assumption.
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심화 해설

Core concept: Andragogy and adult learning assumptions

The correct answer is 1. Adults learn best when the content helps with problems they face now. This reflects Malcolm Knowles’ central assumption that adult learners are oriented toward immediate application of knowledge. In a barangay senior citizens’ center, participants are more likely to engage when health teaching directly addresses concerns they are experiencing today—such as managing hypertension, preventing falls, understanding medication schedules, or coping with vision and hearing changes—rather than content organized for some distant future use.

Knowles described adults as self-directed learners who bring rich life experience, want learning that solves current problems, and are motivated from within. This is the foundation of andragogy as applied in nursing and health education. When the nurse plans sessions for older adults with sensory impairments and a participant who speaks only her indigenous language, the planning must begin with the learners’ present problems and readiness to learn. A session on “how to read your blood pressure log today” is more meaningful than a general lecture on cardiovascular anatomy for later reference.

Key point! Andragogy assumes that adults enter a learning situation with a problem-centered orientation. They ask, “How does this help me now?” In contrast, traditional pedagogy often uses a subject-centered orientation, where content is sequenced logically by discipline and stored for future application. Option 3 describes this pedagogical model, not andragogy.

Watch out! Option 2 (“teacher decides all the content”) contradicts the andragogical principle of self-directedness. Knowles emphasized that adults need to be involved in planning and evaluating their own learning. A nurse who unilaterally decides everything ignores the learners’ experience and autonomy. Option 4 (“teacher rewards each right answer”) relies on external motivation, whereas andragogy holds that adults are primarily internally motivated—by improved quality of life, self-esteem, or better health outcomes, not by tokens or praise from an instructor.

The critique by Darbyshire [1] is useful for exam purposes because it reminds us that andragogy is not a rigid set of techniques but a set of assumptions about adult learners. Even though the author questions whether andragogy is truly distinct from pedagogy, the assumptions themselves—especially problem-centeredness and readiness to learn—remain widely used in nursing education and are frequently tested. For the PNLE/NCLEX, the operational question is: Which assumption best guides the nurse when learners have immediate, real-world health concerns? The answer is always the one that connects learning to current problems.

Knowles’ own work in continuing education for health professionals [2] reinforces this. He argued that the rapid obsolescence of health knowledge means practitioners—and by extension, community members—need learning that can be applied immediately to their roles and responsibilities. For older adults in a barangay setting, the “role” is managing chronic conditions, navigating the health system, and maintaining independence. A teaching session built around those present-day tasks fits andragogy far better than a curriculum organized by subject matter for later recall.

The phenomenological study on nurse orientation [3] and the BLS training framework [4] both apply andragogy in practice by linking content to the learner’s current clinical or life context. In the senior citizens’ center, this translates to assessing what health problems participants are facing right now—for example, difficulty hearing medication instructions, trouble reading small print on prescriptions, or cultural beliefs about illness—and then designing teaching that addresses those problems directly. The nurse should also account for sensory and language barriers by using large-print materials, speaking clearly and facing the audience, and arranging for an interpreter or culturally appropriate visual aids for the indigenous participant.

OptionLearning orientationAndragogy or pedagogy?Why it fits or fails
1Problem-centered, immediate applicationAndragogyMatches Knowles’ assumption that adults learn best when content solves current problems
2Teacher-controlled, content decided by instructorPedagogyIgnores adult self-directedness and learner input
3Subject-centered, arranged for future usePedagogyDelays application; adults prefer learning they can use now
4External reward-drivenNeither core andragogyRelies on extrinsic motivation, not internal motivation


In the clinical reasoning of a licensure examinee, the presence of hearing or vision problems and a language barrier does not change the underlying andragogical principle—it strengthens it. These learners need content that is immediately relevant and delivered in a way they can access. A nurse who starts by asking, “What health problem is bothering you this week?” and then builds the session around that answer is applying andragogy correctly. A nurse who follows a fixed syllabus “for later” is not.
References (research sources)
  • [1]
    In defence of pedagogy: a critique of the notion of andragogy.Research articleDarbyshire P (1993) · DOI: 10.1016/0260-6917(93)90072-a
  • [2]
    Application in continuing education for the health professions: chapter five of "Andragogy in Action".Research articleKnowles MS (1985) · DOI: 10.1002/chp.4760050212
  • [3]
    Clinical Reflections of a Nurse Orientation Programme From an Andragogical Perspective: A Descriptive Phenomenological Study.Research articleÇayak S, Öztürk Demir S, Çavuşoğlu C. (2026) · DOI: 10.1002/nop2.70732
  • [4]
    A practice-oriented framework for basic life support training of Brazilian school teachers: integrating Law 13,722/2018, andragogy, and the health belief model.Research articleCarvalho Castanha CS, Guerrero Daboin BE, Zangirolami-Raimundo J, Barbosa Tavares LF, de Abreu LC, Raimundo RD. (2025) · DOI: 10.3389/fpubh.2025.1616459

임상 시나리오

Andragogy in Community Health TeachingPlanning for Adult Learners with Sensory and Language Barriers

Knowles' andragogy assumes adults are problem-centered learners who engage best when content addresses immediate needs they face now, such as managing hypertension or preventing falls.

For older adults with hearing or vision impairments and a participant speaking only her indigenous language, begin planning from the learners' current problems and readiness to learn, not a predetermined subject sequence.

Caution

Avoid teacher-controlled, subject-centered content for future use or reliance on external rewards; these reflect pedagogy and undermine adult motivation.

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