# Situation: The nurse at a Rural Health Unit (RHU) holds a monthly class on breastfeeding and infant feeding for pregnant women and mothers of young infants. Several mothers in the class believe that colostrum is dirty and should be thrown away. Which teaching method is MOST likely to change this belief?

> source: MyMerci (mymerci.kr)  
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> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The nurse at a Rural Health Unit (RHU) holds a monthly class on breastfeeding and infant feeding for pregnant women and mothers of young infants.

Several mothers in the class believe that colostrum is dirty and should be thrown away. Which teaching method is MOST likely to change this belief?

## 보기

1. A group discussion where a mother shares why she fed colostrum **✔ 정답**
2. A lecture on the protective content of colostrum for newborns
3. A handout that lists the benefits of colostrum for the infant
4. A demonstration of hand expression followed by return practice

**정답: 1**

## 해설

A belief belongs to the affective domain, which changes best through group discussion, testimonies, and values clarification. Hearing a peer mother's experience lets the group examine the belief together. Lectures and handouts mainly add knowledge, and a demonstration builds a psychomotor skill.

## 심화 해설

The belief that colostrum is dirty is not a knowledge deficit in the usual sense; it is a culturally embedded value judgment about what is clean, safe, or appropriate to give a newborn. Because the belief is held at the level of attitude and values, the teaching method must engage the affective domain rather than simply deliver more facts.

Why a group discussion with a peer testimony works

In the affective domain, learners move through stages of receiving, responding, valuing, and eventually internalizing a new value. A lecture or a handout can present the protective components of colostrum, but it does not directly challenge the underlying belief that colostrum is unclean. A demonstration of hand expression teaches a psychomotor skill; it does not address whether colostrum should be given to the infant at all.

A group discussion in which one mother shares why she fed colostrum allows the group to examine the belief together. Hearing a peer describe her own decision creates social permission to reconsider a cultural norm, because the message comes from someone with shared lived experience rather than from an authority figure. This aligns with values clarification, where learners compare their current belief with an alternative perspective in a safe, interactive setting.

Key point! When a mother says colostrum is dirty, the barrier is not lack of information. The barrier is a cultural belief. Peer testimony and group discussion are the most effective teaching methods for changing beliefs because they target the affective domain.

The evidence from rural and pastoralist settings supports this approach. In eastern Ethiopia, qualitative findings showed that infant feeding practices are strongly shaped by community norms, traditional beliefs, and social structures rather than by individual knowledge alone [2][3]. In a tribal district of Maharashtra, strong cultural norms were identified as a factor influencing exclusive breastfeeding practices [4]. Similarly, prelacteal feeding practices in eastern Turkey were associated with cultural and family influences that deprived newborns of colostrum [1]. These studies consistently show that feeding beliefs are embedded in social context, which is precisely why a peer-led group discussion is more likely to shift a belief than a didactic lecture or written material.

| Teaching method | Domain targeted | Effect on the belief that colostrum is dirty |
| --- | --- | --- |
| Group discussion with peer testimony | Affective | Directly challenges the belief through shared experience and values clarification |
| Lecture on protective content | Cognitive | Adds knowledge but may not override a culturally held belief |
| Handout listing benefits | Cognitive | Provides facts but is passive and easily dismissed |
| Demonstration with return practice | Psychomotor | Builds hand expression skill but does not address whether colostrum should be fed |

Watch out! Do not confuse the domain of the problem with the domain of the teaching method. The problem here is a belief, so the correct teaching method must be one that changes beliefs, not one that adds knowledge or builds a skill. A lecture or handout would be appropriate if the mother did not know what colostrum contains. A demonstration would be appropriate if the mother did not know how to express colostrum. But when the mother believes colostrum is dirty and should be discarded, the most effective intervention is a group discussion where a peer shares her experience of feeding colostrum [1][2][3][4].References (research sources)

- [1]Determination of the frequency and predictors of prelacteal feeding practices of mothers in Eastern Turkey.Research articleKurt Can E, Can V, Bulduk M, Ayşin N, Karasungur R, Dilbilir Y. (2026) · DOI: 10.1186/s12889-026-28052-2

- [2]A mixed-methods investigation of infant and young child feeding practices in rural Ethiopia: integrating insights from surveys, direct observation, and qualitative research.Research articleAhmed IA, Ojeda A, Slanzi C, Tiwari C, Hassen JY, Havelaar AH, McKune S. (2026) · DOI: 10.3389/fnut.2026.1794352

- [3]Sociocultural and structural influences on infant and young child feeding in pastoralist communities of Afar, Ethiopia: a qualitative phenomenological study.Research articleAli AS, Belachew T, Shaka MF, Yimer AS, Abate KH. (2026) · DOI: 10.1136/bmjopen-2026-119509

- [4]Assessment of exclusive breastfeeding practices in a tribal district of Maharashtra: A cross-sectional study.Research articleHadaye RS, Pereira QT. (2026) · DOI: 10.4103/jpgm.jpgm_89_26

## 임상 시나리오

Changing Cultural Beliefs in Health TeachingAffective domain strategies for colostrum rejection
When a mother says colostrum is dirty, the barrier is not a knowledge deficit but a cultural belief held in the affective domain. Teaching must engage attitudes and values, not just deliver facts.

The most effective method is group discussion with peer testimony. Hearing a mother share why she fed colostrum creates social permission to reconsider the norm because the message comes from shared lived experience, not an authority figure.

Lectures and handouts mainly target the cognitive domain by adding knowledge about colostrum contents. Demonstration with return practice builds a psychomotor skill such as hand expression. Neither directly challenges the underlying belief.

CautionDo not rely on factual teaching alone when a cultural value is the barrier. Use values clarification and peer discussion to help learners compare their current belief with an alternative in a safe, interactive setting.

## 핵심 개념

- **Affective domain** — Learning domain involving attitudes, beliefs, values, and emotions; best changed through discussion, testimony, and values clarification.
- **Values clarification** — A teaching strategy that helps learners examine and compare their current beliefs with alternative perspectives in a safe setting.
- **Peer testimony** — A firsthand account from someone with shared lived experience, which creates social permission to reconsider a cultural norm.
- **Colostrum** — The first breast milk, rich in protective factors; sometimes culturally misperceived as dirty or unsafe.

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