1. The document discusses learning and behavioral medicine. It provides definitions of learning from various psychologists and educationists. 2. Key aspects of learning discussed include it being a process of acquiring knowledge, attitudes and skills through experience. It is influenced by one's environment and can take place anywhere. 3. The document also examines theories of learning including Thorndike's trial and error theory, Pavlov's classical conditioning, and Skinner's operant conditioning theory. It provides examples and explanations of each.

1. LEARNING AND
BEHAVIORAL MEDICINE
AYO NELSON
CLINICAL INSTRUCTOR
LIRA INSTTITUTE OF HEALTH AND MANAGEMENT SCIENCES
EMAIL: ayonelson617@gmail.com

2. What is learning?
• Answer to this question has been attempted by many psychologists
and educationists. Learning is not something that takes place within
the boundaries of a classroom; rather it takes place anywhere, anytime
and from anyone.
• Traditional Indian Literature has examples where people learnt from
trees, mountains, rivers, insects, etc. It means learning is something
which is possible anywhere. In order to understand the concept of
learning, let us begin with few definitions of learning which many
psychologists and educationists have proposed.

3. LEARNING CONT………….
Learning
• Learning is the process by which an individual acquires knowledge,
attitudes and skills that are necessary to meet the demands of life
• This is the process of acquiring new or modifying existing
knowledge, behaviors, skills, values or preferences.
• One of the most important characteristics of human beings is their
capacity to learn. An individual starts learning immediately after
birth.

4. OTHER DEFINITIONS
• 1.Gardener Murphy: “The term learning covers every modification in
behavior to meet environmental requirements.”
• 2. Henry P. Smith: “Learning is the acquisition of new behavior or the
strengthening or weakening of old behavior as the result of experience.”
• 3. Crow & crow: “Learning is the acquisition of habits, knowledge &
attitudes. It involves new ways of doing things and it operates in individuals
attempts to overcome obstacles or to adjust to new situations. It represents
progressive changes in behavior. It enables him to satisfy interests to attain
goals
• 4. Hurlock (1942) : Learning is development that comes from exercise and
effort. Through learning, children acquire competence in using their
hereditary resources.
• 5. Hilgard, Atkinson and Atkinson (1979): Learning may be defined as a
relatively permanent change in behaviour that occurs as the result of prior
experience.

5. NATURE/CHARACTERISTICS OF
LEARNING
• Learning is a process and not a product: Learning is a lifelong process of
gaining and using the information presented to a person. It is not static. A
person never stops acquiring new information. It keeps a person’s mind
active and aware but also conscious of the world around them
• Learning is purposive or goal directed: when the aim and purpose of
learning is clear, an individual learns immediately. It is the purpose or goal,
which determines what, the learner sees in the learning situations and how
he acts. If there is no purpose or goal learning can hardly be seen.
• Learning generally involves some degree of permanence: To constitute
learning, the change should be permanent. Temporary changes may be only
reflective and fail to represent any learning.

6. NATURE…….
• Learning involves change. It is a reconstruction, combined thinking, skill,
information and appropriation in a single unity process. For example, when
a child learns to read they can retain this knowledge and behavior for the
rest of their lives.
• Learning is universal and continuous: Every creature till it lives, learns.
In human beings it is not restricted to any particular age, sex, race or
culture. It is a continuous never-ending process which starts from birth and
continues till death
• Experience is Necessary for Learning: Some sort of experience is
necessary for learning. We can get the experience from direct observation or
from formal approaches to learning such as training, mentoring, coaching
and teaching.

7. NATURE…….
• Learning is comprehensive: The scope of learning is spread over each and
every dimension of life. It is a very comprehensive process which covers all
domains – Cognitive, Affective and Psychomotor- of human behaviour.
• Learning is organizing experience: Learning involves all those experience
and training of an individual (right from birth) which help her/him to
produce changes in behaviour. It is not mere addition to knowledge or mere
acquisition of facts. It is the reorganization of experience which may also
include unlearning.
• Learning prepares for adjustment: Learning helps the individual to adjust
herself/himself adequately and adapt to the changes that may be necessary
to the new situations.

8. TYPES OF LEARNING
Learning has been classified in many ways.
1. Informal, formal and non-formal learning:
• Informal learning is incidental. It takes place throughout life. It is not
planned.
• Formal learning is intentional and organized. It takes place in formal
educational institution.
2. Individual or Group learning: Learning is called either individual
or group learning depending upon the number of individuals involved in
the learning process.

9. III. Another classification involves the types of activity involved
a) Motor learning: - when learning involves primarily the use of
muscles it is called as motor learning. e.g.: learning to walk, to
operate a typewriter
b) Discrimination learning: - Learning which involves the act of
discrimination is called discrimination learning. e.g. infant
discriminates between mother and aunt, milk and water.
c) Verbal learning: - when learning involves the use of words it is
called as verbal learning.
d) Concept learning: - when learning involves the formation of
concept it is called as concept learning.
e) Sensory learning: - when learning is concerned with perception and
sense it is sensory learning.

10. THEORIES OF LEARNING
• There are three theories of learning
1. Try and error theory of learning
2. Classical Conditioning
3. Operant Conditioning

11. E.L Thorndike- Trial and Error Theory of
Learning:
• S-R (Stimulus-Response) theory with reinforcement
• Edward Lee Thorndike (1874-1949) was the first American
psychologist who put forward the Trial and Error Theory of learning.
• According to Thorndike, all learning takes place because of formation
of bond or connection between stimulus and response. He further says
that learning takes place through a process of approximation and
correction.
• A person makes a number of trials, some responses do not give
satisfaction to the individual but he goes on making further trials until
he gets satisfactory responses.
• Thorndike conducted a number of experiments on animals to explain
the process of learning. His most widely quoted experiment is with a
cat placed in a puzzle box.

12. Trial and Error Theory……….
• Thorndike put a hungry cat in a puzzle box. The box had one door,
which could be opened by manipulating a latch of the door. A fish was
placed outside the box.
• The cat being hungry had the motivation of eating fish outside the box.
However, the obstacle was the latch on the door. The cat made random
movements inside the box indicating trial and error type of behaviour
biting at the box, scratching the box, walking around, pulling and
jumping etc. to come out to get the food.
• Now in the course of her movements, the latch was manipulated
accidently and the cat came out to get the food. Over a series of
successive trials, the cat took shorter and shorter time, committed less
number of errors, and was in a position to manipulate the latch as soon
as it was put in the box and learnt the art of opening the door.

13. Trial and Error Theory……….
• Thorndike concluded that it was only after many random trials that the
cat was able to hit upon the solutions. He named it as Trial and Error
Learning.
• Analysis of the learning behaviour of the cat in the box shows that
besides trial and error the principles of goal, motivation, explanation
and reinforcement are involved in the process of learning by Trial and
Error.

14. LAWS OF LEARNING
• Based on Trial and Error Learning Theory, Thorndike gave certain
laws of Learning. We shall discuss three fundamental Laws of
Learning in this section. These laws are:
• Law of readiness
• Law of effect
• Law of exercise/use

15. 1. Law of Readiness
• This law refers to the fact that learning takes place only when the learner
is prepared to learn. No amount of efforts can make the child learn if the
child is not ready to learn. In other words, if the child is ready to learn,
he/she learns more quickly, effectively and with greater satisfaction than if
he/she is not ready to learn.
2. Law of Exercise
This law explains the role of practice in learning. According to this law,
learning becomes efficient through practice or exercise. The dictum
‘Practice makes a man perfect’ goes very well with this law. This law is
further split into two parts; Law of use and Law of disuse
a) The law of use means that a connection between a stimulus and response is
strengthened by its occurrence, its exercise or its use. In other words, the
use of any response strengthens it, and makes it more prompt, easy and
certain

16. • Regarding the law of disuse, it is said that when a modifiable
connection is not made between a stimulus and a response over a
length of time, the strength of that connection is decreased. This
means that any act that is not practiced for some time gradually
decays. Anything that is not used exercised or practiced for a certain
period tends to be forgotten or becomes weak in strength, efficiency
and promptness.

17. 3. Law of Effect
• This is most important of Thorndike’s laws, which state that when a
connection between stimulus and response is accompanied by satisfying
state, its strength is increased.
• On the other hand, when a connection is accompanied by an annoying state
of affairs, its strength is reduced or weakened.
• In other words, the responses that produce satisfaction or comfort for the
learner are strengthened and responses that produce annoyance or
discomfort for the learner are weakened. Thorndike revised this law in 1930
and according to this revision, he stated that reward strengthened the
response but punishment did not always weaken the response. Then he
placed more emphasis on the reward aspect than on the punishment aspect
of Law of Effect.

18. Other Laws……
 Law of Primacy
• Things learned first are usually learned easily and remain without effort in
the mind of the student.
 Law of Purpose
• With a clear or definite goal in mind, the student works towards a definite
purpose.
 Law of intensity
• The more intense the material taught the more likely it will be retained. e.g. a
sharp vivid dramatic or exciting learning experience teaches more than a routine
or boring experience.
 Law of requirement
• It states that we must have something to obtain or do something i.e. it can be
ability, skill, instrument or anything that may help us to learn or gain something.
 Law of freedom
• It states that things freely learned are best learned.

19. CLASSICAL CONDITIONING THEORY OF
LEARNING
• Classical conditioning refers to learning that occurs when a neutral
stimulus (e.g., a tone) becomes associated with a stimulus (e.g., food)
that naturally produces a behavior.
• Classical conditioning is a term used to describe learning which has
been acquired through experience.
• The theory of classical conditioning was proposed by Ivan Pavlov
(1849-1936), a Russian physiologist. Pavlov, while studying the
physiology of digestion; found that behavior can be classically
conditioned. He experimented on a dog

20.  and found that food placed in the mouth of a hungry dog
automatically causes salivation. In this case, salivation is an
unlearned response, or an unconditioned response and the food is
an unconditioned stimulus (natural).
 Later on, a bell was rung each time before the food was presented.
Pavlov now found that the dog started to salivate at the sound of the
bell and this was termed as a conditioned response. The bell is a
conditioned stimulus (artificial stimulus).
 In later studies Pavlov noticed that if he did not provide food after the
bell was rung, the dog eventually stopped salivating called
‘extinction’ and demonstrated that reinforcement is essential both to
acquire and maintain respondent learning.
 Pavlov also found that if the dog is given a prolonged rest

21. period during extinction, it will once again salivate when the bell is
rung. This phenomenon is called as spontaneous recovery.
 Prior to conditioning, the ringing of a bell does not bring about
salivation — making the bell a neutral stimulus. On the other hand,
food naturally brings about salivation, making the food an
unconditioned stimulus and salivation an unconditioned response.
 During conditioning, the bell is rung just before the presentation of
the food.
 After conditioning, the ringing of the bell alone brings about
salivation. The bell which was earlier considered as neutral stimulus
is now considered as conditional stimulus bringing about
conditioned response of salivation.

22. Summary
• Phase 1: Before Conditioning
• The first part of the classical conditioning process requires a naturally
occurring stimulus that will automatically elicit a response. Salivating in
response to the smell of food is a good example of a naturally occurring
stimulus.
• During this phase of the processes, the unconditioned stimulus (UCS)
results in an unconditioned response (UCR).
• For example, presenting food (the UCS) naturally and automatically triggers
a salivation response (the UCR).
• At this point, there is also a neutral stimulus that produces no effect . Not
until this neutral stimulus is paired with the UCS that it will come to evoke
a response

23. Note
• The unconditioned stimulus is one that unconditionally, naturally,
and automatically triggers a response. For example, when you smell
one of your favorite foods, you may immediately feel very hungry. In
this example, the smell of the food is the unconditioned stimulus.
• The unconditioned response is the unlearned response that occurs
naturally in response to the unconditioned stimulus. In our example,
the feeling of hunger in response to the smell of food is the
unconditioned response.

24. Phase 2: During Conditioning
• During the second phase of the classical conditioning process, the
previously neutral stimulus is repeatedly paired with the unconditioned
stimulus. As a result of this pairing, an association between the
previously neutral stimulus and the UCS is formed. At this point, the
once neutral stimulus becomes known as the conditioned stimulus
(CS). The subject has now been conditioned to respond to this
stimulus
• The conditioned stimulus is neutral stimulus that, after becoming
associated with the unconditioned stimulus, eventually comes to
trigger a conditioned response.

25. Phase 3: After Conditioning
• Once the association has been made between the UCS and the CS,
presenting the conditioned stimulus alone will come to evoke a
response even without the unconditioned stimulus. The resulting
response is known as the conditioned response (CR).
• The conditioned response is the learned response to the previously
neutral stimulus. In our example, the conditioned response would be
feeling hungry when you heard the sound of the whistle.

26. Other terms
 Acquisition: this is the (acquiring)learning of the behavior in response to an
unconditioned stimulus(UCS). E.g salivating in response to hearing a bell.
 Extinction: This is when a conditioned response (CS) decreases and eventually fades if
the conditioned stimulus is not followed by an unconditional stimulus.(e.g a dog stops
salivating on hearing the bell when food is not brought.)
 Spontaneous Recovery: This is when a conditional stimulus regains the ability to elicit
a conditional response
 Stimulus Generalization: A response to a new stimulus (any sound) that resemblesthe
conditioned stimulus (sound of a bell ringing) resulting in the conditioned response
(salivating of the dog).
• Stimulus discrimination: Here the object learns to differentiate between the
conditioned stimulus (CS) to any other stimulus similar to it. (i.e the dog learns to
differentiate sound of a car hooting to sound heard from the bell so as to salivate).
• Aversive Conditioning: an unwanted behavior (e.g drinking alcohol) is paired with
painful or aversive stimulus ((e.g medication that causes nausea). Ideally, this pairing
creates an association between the unwanted behavior and the aversive stimulus and
alcohol drinking ceases.

28. OPERANT CONDITIONING/
INSTRUMENTAL CONDITIONING
• The theory of learning by operant conditioning was given by BF Skinner
(1904-1990).
• Basically Skinner revolted against the concept of classical conditioning. He
said that man is an active organism, and not a victim of his environment.
He does not wait for the stimulus; instead, he acts or operates on the
environment, so as to change it in some way. Thus, he called it as operant
behavior.
• According to Skinner, operant behavior is determined by the events or
consequences that follow the response. If the consequences are favorable,
the individual will repeat the same behavior. In this case, the consequences
are said to have provided positive reinforcement and cause repetition of
the behavior.

29. • Alternatively, if the consequences are unfavorable, they reduce the
chances of the same behavior from getting repeated. In such a case,
the consequences are said to have provided negative reinforcement
and reduce the chances of the behavior from recurring again.
• Thus, operant conditioning is called as type-R conditioning, to
emphasize the effect of the response on future behavior. In this way
Skinner said that learning is shaped and maintained by its
consequences.
• The Experiment
 A hungry rat was placed in a box designed by Skinner, which was
known as the Skinner box or operant chamber. The chamber
contained a lever which would drop food pellets into it(chamber) if
pressed.

30.  In the beginning the experimenter himself dropped the food pellets into
the box and later stopped. The rat, being hungry, began to explore the
box and pressed the lever accidentally. The food pellet was released into
the box and the rat ate it up.
 After a while, it pressed the lever again and ate the food pellet, which
got released. After the third or fourth time, the rat began to press the
lever more rapidly.
 Thus, the food is said to have provided positive reinforcement to the
rat and operant behavior got established, i.e. the rat continued to press
the lever, in order to obtain the food pellets. Based on the findings of his
experiments, he concluded that behavior is shaped and maintained by its
consequences. It is operated by the organism and maintained by its
results.

33. Principles
1. Behavior is determined by its consequences; for the individual the
consequence, or reinforcement, occurs immediately following behavior.
2. In operant conditioning, a behavior that is not part of the individual’s
natural repertoire can be learned through reward or punishment.
Elements used.
• The likelihood that a behavior will occur is increased by reinforcement and
decreased by punishment.
Reinforcement
• The process, by which a stimulus increases the probability that a preceding
behavior will be repeated
 Positive Reinforcement (reward): is the introduction of a pleasant
(positive) stimulus that increases the rate of behavior.
 Negative Reinforcement (escape): is the removal of an aversive or
unpleasant behavior that increases the rate of behavior. eg turning off an
electric shock when a prisoner gives some useful information

35. Punishment:
• Is the introduction of an aversive stimulus aimed at reducing the rate
of an unwanted behavior.
• Or A stimulus that decreases the probability that a previous behavior
will occur again.
• Qn: Define negative and positive punishment.
Extinction in operant conditioning:
• is the gradual disappearance of a learned behavior when
reinforcement is reduced.

37. Factors Influencing Learning
• Learning is a process of bringing relatively permanent change in
behavior of the learner through experience or practice.
• The learning process is centered on three elements:
 The learner, whose behavior is to be changed or modified.
 The type of experience or training required for modification in the
learner’s behavior.
 The men and material resources needed for providing desired
experiences and training

38. Factors associated ……………
Factors associated with the learner him/herself
• Learner’s physical health: Fever, sensory defects particularly of the
eyes or the ears, malnutrition, loss of sleep and fatigue are some of
the physical handicaps that hinder effective learning
• Learner‘s mental health: Experiments have shown that worries,
fears, persistent day dreams; feelings of loneliness and inferiority
affect learning. If the learner has no self-confidence, self-reliance or
self- respect due to the attitudes of teachers or others, it is very
difficult for him or her to learn well
• Basic potential of the learner:

39.  Learner’s innate abilities and capacities for learning.
 Learner’s general intelligence, knowledge, understanding skills, etc.
 Learner’s basic interest, aptitudes and attitudes related to the learning of a
particular thing or area.
• The level of motivation: The stronger and clearer the motive in learning
anything, the greater is the effort and interest shown by the learner in
learning it. The result is greater and more permanent learning.
• Goals of life: The philosophy of immediate as well as ultimate goals of
one’s life affects the process and product of learning.
• Readiness and willpower: A learner’s readiness and willpower to learn is
a great deciding factor of his results in learning. If the learner has a will to
learn a thing, he finds a way for effective learning.

40. • Maturation: Maturation helps in the process of learning. We learn
things, when we are mature to learn them. Maturation and learning are
closely related to each other.
• Age: There are certain limitations that old people face in learning new
things. They are physically weak and their ability to learn is slow. They
have a poor recent memory and their reasoning speed decreases.
• Emotions: Tension or anxiety is a double-edged emotion. It has a
positive as well as a negative effect on learning. Some amount of stress
or anxiety is essential for learning. It provides the drive to learn.
• Sex: Although no sex is superior to the other, certain differences in
interests and aptitudes are found between the two sexes. Females like to
learn things that involve people, while men are more object- oriented

41. Factors Associated with type of Learning
Experience
• Nature of learning experience: Learning is influenced by the nature of
the subject matter and the learning experiences presented to a learner,
such as formal or informal, incidental or well planned, direct or indirect.
• Methodology of learning: Learning depends upon the methods,
techniques and approaches employed for the teaching and learning of
the selected contents. Some of these techniques are:
 Linking the recent learning with those of the past.
 Correlating learning in one area with that of another.
 Utilization of maximum number of senses. Revision and practice.
 Provision of proper feedback and reinforcement.

42. • Meaningfulness of material: The more meaningful the material, the
faster it is learned.
• Amount or length of material: Learning is influenced considerably
by the amount and length of the material to be learned. In general,
more the amount of material to be learned, more the time the person
will take to learn it.