Many health educators don’t understand why it’s necessary for them to write goals and objectives. To their way of thinking, they should be doing patient education instead of wasting time planning it. To me that makes no sense at all, so I’d like you to think about one thing. How do you know what to teach if you don’t know what you want the learner to know at the end of the class?

I remember the first time I realized that goal setting was one of the most important tools an educator had and that it should be done for every class. I said to myself, “What do I want this person to know when I finish the class?” Light on! At that point I knew that if I wanted to know what to teach, I had to know what I wanted my audience to learn.

A simple goal – the first step

A goal is a broad statement of what you want to accomplish. That’s it! Just that! It is short, clear and concise. It doesn’t say how you are going to do it, who is going to teach, when it will be done and how it will be accomplished? Keep it simple.

For example, if I want to use this process to clean my living room, I would write a specific goal. It is very clear.

A goal is a broad statement of what you want to accomplish … Keep it simple.

The GOAL: I will have a clean living room. That’s it! I WILL HAVE A CLEAN LIVING ROOM, a broad statement of what I want to accomplish. Short and simple. It doesn’t define clean. It doesn’t say who is going to clean it. It doesn’t say when it will be clean and it certainly doesn’t say how long it will stay clean.

Let’s use that approach for a diabetes education program and look at some sample goals:

• The patient will be able to count carbohydrates in a sample meal
• The patient will be able to test their blood sugar using a blood glucose meter.
• The patient will be able to self-administer their insulin.

Here are two goals for a post-operative patient:

• The patient will be able to change their dressing.
• The patient will be able to identify signs and symptoms of infection.

Each of these goals tells you what you will have to teach in the class. They are all clear, simple, concise, and short.

Now you may be saying, “Wait a minute! Those are all things the patient has to do.” That doesn’t mean you only write goals for physical skills. You are still measuring what a person has to learn.

You will notice there is a word I never use.  Know. The objective that comes to me stating that the patient or learner will know something goes right into the trash. I get thousands of brochures each year for workshops and seminars. I immediately look at the goals and objectives. After all, I want to know what I’m going to learn if I go to the workshop. If the brochure says that I’ll know something, I want to know how they will know that I know it. Will I sit and glow in the dark or will I sit and grin at them after the program.

There is another word that makes me ballistic, Recognize. How will the instructor know if I recognize. Will I get all excited and jump up and down. This makes me very discouraged in our learning process when I see that written by otherwise excellent instructors.

If the brochure says I will know about Syndrome X, I want to know what I will have to do to prove that I have learned that. Think about it. Will I have to take a test, write a sworn statement, or testify in court? I need to know that up front because if an examination is involved you will never see me in that class. I bet you feel the same way. It makes me crazy.

Patients have the same rights to know what they are expected to learn and what you will expect them to be able to do at the end of the class.

Take a look at the goals that I gave you for a diabetes program.  They tell me what I have to do, but give me all the freedom I need to be as creative as I want to. If I presented this to my boss, it would give her an idea of what we would wind up with.

Objectives get you there

The next question would be how am I going to get there? That requires objectives. An objective is a simple statement that clearly says what the person will be able to do at the conclusion of the session to prove that they have learned something.

Here are some examples of what you will be able to do at the conclusion of reading this article. I should have given this to you in the beginning of the article, right? Now you know better.

At the conclusion of reading this article, the learner will be able to:

• Define a goal.
• Write a goal for any patient education class.
• Define an objective.
• Explain the difference between a goal and an objective.
• Write 5 objectives for any class.

Do you now have a clear idea of what will be taught in this article? It’s the same thing when developing objectives for any class. The objective tells you what the content of your class must include.

I often talk to new instructors and the minute they are planning a class, they sit down to write content. How can you do that if you do not know what you want the learner to know at the end of the class? Did you just notice the word know??? The key question is, what do I want the learner to be able to do in order to prove they know something?

Remember the goal for cleaning my living room? It was,  “I will have a clean living room.” Now, here are the objectives. At the conclusion of the cleaning (this tells me when) by my cleaning woman Ethel (this tells me who is going to do it), there will be these final results (this tells me what will be accomplished):

• No dust on the furniture
• No dirt on the floor
• No magazines on the coffee table
• No shoes under the couch
• No gum under the mantle.

If these things are true do I have a clean living room? To me it is clean. I also know, or Ethel will know what I consider needs to be done in order to have a clean living room. You may consider other things need to be done for the room to be clean. Fine. Write those objectives for cleaning your living room. This is good enough for me.

Three domains

This brings us to the subject of domains. Bloom’s taxonomy defines educational objectives at three levels; cognitive, psychomotor and affective.

A taxonomy is defined as a “mechanism used to categorize things according to their relationships to one another.

The cognitive domain relates to knowledge. What does the person know, or need to know, and how do you measure what they know? When you write the objective ask yourself what does this person have to do to prove that he knows this subject?

An objective is a simple statement that clearly says what the person will be able to do … to prove that they have learned something.

At this point you use an active verb. He has to explain, describe, identify, list, etc. If the objective says that he will explain the difference between type 1 and type 2 diabetes, then you need to explain the difference in your class. If the objective says he will list the signs and symptoms of type 2 diabetes, then that is the content and it must be delivered in the format of a list. These are the easiest objectives to write and I find very few instructors who have difficulty conceptualizing knowledge in this framework

The psychomotor domain relates to a physical skill. If you want to find out if the person can achieve a physical skill, have them show you that they can do it. An objective may be this. At the conclusion of the class the learner will be able to return demonstrate how to use a lancing device to obtain blood for glucose testing.

This is very simple and easy to write and accept. These are the physical skills that patients need and very easy to prove. These are called competency-based skills. The person can or cannot administer insulin.

The affective domain relates to attitudes or feelings. This is the hardest domain to deal with, whether it is writing objectives, measuring them or teaching. What can you say or ask that will prove how a learner feels about something?

Let’s say you discussed all the complications of diabetes that can occur if patients do not achieve glycemic control? Then you led a group discussion on the importance of tight control and the DCCT study? At that point you might have an objective that says this. At the conclusion of the session the participant will be able to discuss how he will control his blood sugar and the ramifications that could occur with poor control.

This objective shows that the patient has discussed the importance and accepts that there are ramifications and actually talks about his feelings.

Behavioral objectives

Let’s write a goal and three objectives, sometimes referred to as terminal behavior objectives, for self-monitoring of blood glucose (SMBG). Just to make it interesting we will do one for each of the domains.

Goal: The person with diabetes will be able to SMBG.

Objectives: At the conclusion of the class the participant will be able to:

• List the times and reasons for blood glucose testing (cognitive domain).
• Return demonstrate how to test their blood on their own meter (psychomotor domain)
• Explain how SMBG gives them control to make decisions about how they manage their diabetes (affective domain).

Is it worth it?

This may seem like a lot of work, but it clarifies what you must do in order to effectively develop the content of your patient education classes. Let’s look at the objectives for this article again.

At the conclusion of this article the learner will be able to:

• Define a goal.
• Write a goal for any patient education class.
• Define an objective.
• Explain the difference between a goal and an objective.
• Write 5 objectives for any class.

If you can do these things I have met my objectives and therefore my goal. Have fun!