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Chapter 3
Applying Learning Theories to
Healthcare Practice
LEARNING
• Learning: a relatively permanent change
in mental processing, emotional
functioning, and behavior as a result of
experience
• Learning Theory: a coherent framework
of integrated constructs and principles
that describe, explain, or predict how
people learn
CONTRIBUTION OF LEARNING
THEORIES
• Provide information and techniques to
guide teaching and learning
• Can be employed individually or in
combination
• Can be applied in a variety of settings as
well as for personal growth and
interpersonal relations
Application Questions to Keep in Mind
• How does learning occur?
• What kinds of experiences facilitate or
hinder the process?
• What helps ensure that learning becomes
permanent?
BEHAVIORIST THEORY
• Concepts: stimulus conditions,
reinforcement, response, drive
• To change behavior, change the stimulus
conditions in the environment and the
reinforcement after a response.
Behaviorist Dynamics
• Motivation: drives to be reduced,
incentives
• Educator: active role; manipulates
environmental stimuli and
reinforcements to direct change
• Transfer: practice and provide similarity
in stimulus conditions and responses
with a new situation
Respondent Conditioning
• Learning occurs as the organism
responds to stimulus conditions and
forms associations.
• A neutral stimulus is paired with an
unconditioned stimulus–unconditioned
response connection until the neutral
stimulus becomes a conditioned stimulus
that elicits the conditioned response.
Operant Conditioning
• Learning occurs as the organism
responds to stimuli in the environment
and is reinforced for making a particular
response.
• A reinforcer is applied after a response,
strengthening the probability that the
response will be performed again under
similar conditions.
Changing Behavior Using Operant
Conditioning
• To increase behavior
– Positive reinforcement
– Negative reinforcement (escape or
avoidance conditioning)

• To decrease behavior
– Nonreinforcement
– Punishment
COGNITIVE THEORY
• Concepts: cognition, gestalt, perception,
developmental stage, informationprocessing, memory, social
constructivism, social cognition,
attributions
• To change behavior, work with the
developmental stage and change
cognitions, goals, expectations,
equilibrium, and ways of processing
information.
Cognitive Dynamics
• Motivation: goals, expectations,
disequilibrium, cultural and group values
• Educator: organize experiences and make
them meaningful; encourage insight and
reorganization within learner
• Transfer: focus on internal processes and
provide common patterns with a new
situation
Gestalt Perspective
• Perception and the patterning of stimuli
(gestalt) are the keys to learning, with
each learner perceiving, interpreting, and
reorganizing experiences in her/his own
way.
• Learning occurs through the
reorganization of elements to form new
insights and understanding.
Information-Processing Perspective
• The way individuals perceive, process,
store, and retrieve information from
experiences determines how learning
occurs and what is learned.
• Organizing information and making it
meaningful aids the attention and storage
process; learning occurs through
guidance, feedback, and assessing and
correcting errors.
Cognitive Development Perspective
• Learning depends on the stage of
cognitive functioning, with qualitative,
sequential changes in perception,
language, and thought occurring as
children and adults interact with the
environment.
• Recognize the developmental stage and
provide appropriate experiences to
encourage discovery.
Social Constructivist Perspective
• Learning is heavily influenced by the
culture and occurs as a social process in
interaction with others.
• A person’s knowledge may not
necessarily reflect reality, but through
collaboration and negotiation, new
understanding is acquired.
Social Cognition Perspective
• An individual’s perceptions, beliefs, and
social judgments are affected strongly by
social interaction, communication,
groups, and the social situation.
• Individuals formulate causal explanations
to account for behavior that have
significant consequences for their
attitudes and actions (attribution theory).
SOCIAL LEARNING THEORY
• Concepts: role modeling, vicarious
reinforcement, self-system, selfregulation
• To change behavior, utilize effective role
models who are perceived to be
rewarded, and work with the social
situation and the learner’s internal selfregulating mechanisms.
Social Learning Dynamics
• Motivation: compelling role models
perceived to be rewarded, self-system
regulating behavior, self-efficacy
• Educator: model behavior and
demonstrate benefits; encourage active
learner to regulate and reproduce
behavior
• Transfer: similarity of setting, feedback,
self-efficacy, social influences
PSYCHODYNAMIC LEARNING THEORY
• Concepts: stage of personality
development, conscious and unconscious
motivations, ego-strength, emotional
conflicts, defense mechanisms
• To change behavior, work to make
unconscious motivations conscious,
build ego-strength, and resolve
emotional conflicts.
Psychodynamic Dynamics
• Motivation: libido, life force, death wish,
pleasure principle, reality principle, conscious
and unconscious conflicts, developmental
stage, defenses
• Educator: reflective interpreter; listen and
pose questions to stimulate insights
• Transfer: remove barriers such as resistance,
transference reactions, and emotional conflicts
HUMANISTIC LEARNING THEORY
• Learning occurs on the basis of a
person’s motivation, derived from needs,
the desire to grow in positive ways, selfconcept, and subjective feelings.
• Learning is facilitated by caring
facilitators and a nurturing environment
that encourage spontaneity, creativity,
emotional expression, and positive
choices.
Humanist Dynamics
• Motivation: needs, desire to grow, selfconcept
• Educator: act as facilitator who respects
learner’s uniqueness and provides
freedom to feel, express, and grow
creatively
• Transfer: positive or negative feelings
and choices as well as freedom to learn,
promote, or inhibit transfer
NEUROPSYCHOLOGY AND LEARNING
• Physiological and neurological bases of
thinking, learning, and behavior
• Neurological conditions, mental health
issues, and learning disabilities
• Relationship between stress and learning
• Integration of learning theories
Generalizations about Learning
• Learning is a function of physiological and
neurological developmental changes.
• Brain processing is different for each learner.
• Learning is active, multifaceted, and complex.
• Meaningful practice strengthens learning
connections.
• Stress can interfere with or stimulate learning.
MOTOR LEARNING
• Motor learning is useful in addition to
theories of psychological learning.
• Examples of skills taught
– Walking
– Putting on a colostomy bag
– Operating sophisticated medical equipment
Stages of Motor Learning
• Cognitive stage
– Learner works to develop cognitive map

• Associative stage
– More consistent performance, slower gains,
fewer errors

• Autonomous stage
– Automatic stage, achieving advanced level
Motor Learning Variables
• Prepractice
– Motivation, attention, goal setting, modeling,
demonstrations

• Practice
– Massed vs. distributed, variability, whole
versus part, random vs. blocked, guidance vs.
discovery learning
Motor Learning Variables (cont’d)
• Feedback
– Intrinsic (inherent) feedback
– Sensory and perceptual information that
arises when a movement is produced
– Extrinsic (augmented or enhanced feedback)
– Provided to learner from outside source
(nurse, biofeedback)
Common Principles of Learning
• Promoting change
– Relate to what learner knows and is familiar
with
– Keep experiences simple, organized, and
meaningful
– Motivate learner (deprivation, goals,
disequilibrium, needs, tension)
– May need incentives and rewards, but not
always
Common Principles of Learning
(cont’d)
• Promoting change
– Experiences must be at the appropriate
developmental level
– Make learning pleasurable, not painful
– Demonstrate by guidance and attractive role
models
Common Principles of Learning
(cont’d)
• Making learning relatively permanent
–
–
–
–

Relate experiences to learner
Reinforce behavior
Rehearse and practice in variety of settings
Have learner perform and give constructive
feedback
– Make sure interference does not occur
before, during, or after learning
Common Principles of Learning
(cont’d)
• Making learning relatively permanent
– Promote transfer
– Have learner mediate and act on experience
in some way (visualize, memory devices,
discuss, talk, discuss, write, motor
movement)
State of the Research Evidence
• Tests and modifies theories, methods,
and assumptions
• Challenges conventional wisdom and
myths
• Interdisciplinary focus is beneficial
• Lack of resources is hindrance
Questions to Consider
• In what ways do the learning theories
differ?
• In what ways are they similar?
• How can the learning theories be used in
combination to change behavior and
enhance learning?
• Why are some theories more effective
with certain individuals than with
others?

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Chapter 3

  • 1. Chapter 3 Applying Learning Theories to Healthcare Practice
  • 2. LEARNING • Learning: a relatively permanent change in mental processing, emotional functioning, and behavior as a result of experience • Learning Theory: a coherent framework of integrated constructs and principles that describe, explain, or predict how people learn
  • 3. CONTRIBUTION OF LEARNING THEORIES • Provide information and techniques to guide teaching and learning • Can be employed individually or in combination • Can be applied in a variety of settings as well as for personal growth and interpersonal relations
  • 4. Application Questions to Keep in Mind • How does learning occur? • What kinds of experiences facilitate or hinder the process? • What helps ensure that learning becomes permanent?
  • 5. BEHAVIORIST THEORY • Concepts: stimulus conditions, reinforcement, response, drive • To change behavior, change the stimulus conditions in the environment and the reinforcement after a response.
  • 6. Behaviorist Dynamics • Motivation: drives to be reduced, incentives • Educator: active role; manipulates environmental stimuli and reinforcements to direct change • Transfer: practice and provide similarity in stimulus conditions and responses with a new situation
  • 7. Respondent Conditioning • Learning occurs as the organism responds to stimulus conditions and forms associations. • A neutral stimulus is paired with an unconditioned stimulus–unconditioned response connection until the neutral stimulus becomes a conditioned stimulus that elicits the conditioned response.
  • 8. Operant Conditioning • Learning occurs as the organism responds to stimuli in the environment and is reinforced for making a particular response. • A reinforcer is applied after a response, strengthening the probability that the response will be performed again under similar conditions.
  • 9. Changing Behavior Using Operant Conditioning • To increase behavior – Positive reinforcement – Negative reinforcement (escape or avoidance conditioning) • To decrease behavior – Nonreinforcement – Punishment
  • 10. COGNITIVE THEORY • Concepts: cognition, gestalt, perception, developmental stage, informationprocessing, memory, social constructivism, social cognition, attributions • To change behavior, work with the developmental stage and change cognitions, goals, expectations, equilibrium, and ways of processing information.
  • 11. Cognitive Dynamics • Motivation: goals, expectations, disequilibrium, cultural and group values • Educator: organize experiences and make them meaningful; encourage insight and reorganization within learner • Transfer: focus on internal processes and provide common patterns with a new situation
  • 12. Gestalt Perspective • Perception and the patterning of stimuli (gestalt) are the keys to learning, with each learner perceiving, interpreting, and reorganizing experiences in her/his own way. • Learning occurs through the reorganization of elements to form new insights and understanding.
  • 13. Information-Processing Perspective • The way individuals perceive, process, store, and retrieve information from experiences determines how learning occurs and what is learned. • Organizing information and making it meaningful aids the attention and storage process; learning occurs through guidance, feedback, and assessing and correcting errors.
  • 14. Cognitive Development Perspective • Learning depends on the stage of cognitive functioning, with qualitative, sequential changes in perception, language, and thought occurring as children and adults interact with the environment. • Recognize the developmental stage and provide appropriate experiences to encourage discovery.
  • 15. Social Constructivist Perspective • Learning is heavily influenced by the culture and occurs as a social process in interaction with others. • A person’s knowledge may not necessarily reflect reality, but through collaboration and negotiation, new understanding is acquired.
  • 16. Social Cognition Perspective • An individual’s perceptions, beliefs, and social judgments are affected strongly by social interaction, communication, groups, and the social situation. • Individuals formulate causal explanations to account for behavior that have significant consequences for their attitudes and actions (attribution theory).
  • 17. SOCIAL LEARNING THEORY • Concepts: role modeling, vicarious reinforcement, self-system, selfregulation • To change behavior, utilize effective role models who are perceived to be rewarded, and work with the social situation and the learner’s internal selfregulating mechanisms.
  • 18. Social Learning Dynamics • Motivation: compelling role models perceived to be rewarded, self-system regulating behavior, self-efficacy • Educator: model behavior and demonstrate benefits; encourage active learner to regulate and reproduce behavior • Transfer: similarity of setting, feedback, self-efficacy, social influences
  • 19. PSYCHODYNAMIC LEARNING THEORY • Concepts: stage of personality development, conscious and unconscious motivations, ego-strength, emotional conflicts, defense mechanisms • To change behavior, work to make unconscious motivations conscious, build ego-strength, and resolve emotional conflicts.
  • 20. Psychodynamic Dynamics • Motivation: libido, life force, death wish, pleasure principle, reality principle, conscious and unconscious conflicts, developmental stage, defenses • Educator: reflective interpreter; listen and pose questions to stimulate insights • Transfer: remove barriers such as resistance, transference reactions, and emotional conflicts
  • 21. HUMANISTIC LEARNING THEORY • Learning occurs on the basis of a person’s motivation, derived from needs, the desire to grow in positive ways, selfconcept, and subjective feelings. • Learning is facilitated by caring facilitators and a nurturing environment that encourage spontaneity, creativity, emotional expression, and positive choices.
  • 22. Humanist Dynamics • Motivation: needs, desire to grow, selfconcept • Educator: act as facilitator who respects learner’s uniqueness and provides freedom to feel, express, and grow creatively • Transfer: positive or negative feelings and choices as well as freedom to learn, promote, or inhibit transfer
  • 23. NEUROPSYCHOLOGY AND LEARNING • Physiological and neurological bases of thinking, learning, and behavior • Neurological conditions, mental health issues, and learning disabilities • Relationship between stress and learning • Integration of learning theories
  • 24. Generalizations about Learning • Learning is a function of physiological and neurological developmental changes. • Brain processing is different for each learner. • Learning is active, multifaceted, and complex. • Meaningful practice strengthens learning connections. • Stress can interfere with or stimulate learning.
  • 25. MOTOR LEARNING • Motor learning is useful in addition to theories of psychological learning. • Examples of skills taught – Walking – Putting on a colostomy bag – Operating sophisticated medical equipment
  • 26. Stages of Motor Learning • Cognitive stage – Learner works to develop cognitive map • Associative stage – More consistent performance, slower gains, fewer errors • Autonomous stage – Automatic stage, achieving advanced level
  • 27. Motor Learning Variables • Prepractice – Motivation, attention, goal setting, modeling, demonstrations • Practice – Massed vs. distributed, variability, whole versus part, random vs. blocked, guidance vs. discovery learning
  • 28. Motor Learning Variables (cont’d) • Feedback – Intrinsic (inherent) feedback – Sensory and perceptual information that arises when a movement is produced – Extrinsic (augmented or enhanced feedback) – Provided to learner from outside source (nurse, biofeedback)
  • 29. Common Principles of Learning • Promoting change – Relate to what learner knows and is familiar with – Keep experiences simple, organized, and meaningful – Motivate learner (deprivation, goals, disequilibrium, needs, tension) – May need incentives and rewards, but not always
  • 30. Common Principles of Learning (cont’d) • Promoting change – Experiences must be at the appropriate developmental level – Make learning pleasurable, not painful – Demonstrate by guidance and attractive role models
  • 31. Common Principles of Learning (cont’d) • Making learning relatively permanent – – – – Relate experiences to learner Reinforce behavior Rehearse and practice in variety of settings Have learner perform and give constructive feedback – Make sure interference does not occur before, during, or after learning
  • 32. Common Principles of Learning (cont’d) • Making learning relatively permanent – Promote transfer – Have learner mediate and act on experience in some way (visualize, memory devices, discuss, talk, discuss, write, motor movement)
  • 33. State of the Research Evidence • Tests and modifies theories, methods, and assumptions • Challenges conventional wisdom and myths • Interdisciplinary focus is beneficial • Lack of resources is hindrance
  • 34. Questions to Consider • In what ways do the learning theories differ? • In what ways are they similar? • How can the learning theories be used in combination to change behavior and enhance learning? • Why are some theories more effective with certain individuals than with others?