Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

L.E.A.R.N.S. Model


Facilitating client centred learning is based on the foundation of four pillars (see Figure 1). These four pillars support client centred learning and encourage self-efficacy and decision-making. Standing on this foundation, the client and nurse are surrounded by a safe environment which is shame- and blame-free. Creation of a safe, shame- and blame-free environment fosters a therapeutic partnership relationship in which the learner and the nurse are able to work together as partners. This partnership relationship is depicted by the intertwining circles, indicating that the nurse and client are equals.
L.E.A.R.N.S. (Listen, Establish, Adopt, Reinforce, Name and Strengthen) is the acronym for the interactions that take place where the client and nurse circles intersect. The L.E.A.R.N.S. Model also signifies the nursing process. By listening to the client’s needs, the nurse is able to understand the client’s perspective, see the client as a whole and begin to build a partnership relationship that is therapeutic and respectful of autonomy, voice and self-determination. Facilitation of client learning is an intentional intervention which recognizes that learning requires information, opportunity to practice new skills, ability to translate new knowledge and skills into the client’s context, assessment of the learning, and the opportunity to enhance comprehension or mastery of the skill which promotes self-efficacy and self-management.
The bidirectional arrows in this conceptual model indicate that learning is not a single event, but an ongoing process which is iterative and shared between the health-care professional and the client. This interaction may also begin in one setting and continue across one or more additional settings such as home, clinic or community. The tenets of the social constructivist theory are interwoven and create the background context for the conceptual model. This model is original and created by the guideline development panel members.