Chapter 3


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Chapter 3

  1. 1. Chapter 3 Applying Learning Theories to Healthcare Practice
  2. 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. 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. 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. 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. 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. 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. 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. 9. Changing Behavior Using Operant Conditioning • To increase behavior – Positive reinforcement – Negative reinforcement (escape or avoidance conditioning) • To decrease behavior – Nonreinforcement – Punishment
  10. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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?