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Learning Theories in Nursing Education

Team 2
UT Tyler
Nursing Education Curriculum Development
NURS 5327
Jerri Post, PhD, RN
February 3, 2016

Learning Theories in Nursing Education

Learning is an intricate operation, with the individual modifying facts and events into
knowledge, abilities, actions and viewpoints. Learning combines reasoning, emotion and
interaction with others and the world around us, so that we gain knowledge, understanding,
skills, a sense of right and wrong and a fundamental orientation to the world. It is more complex
than what could occur with simple physical growth, age or maturity. Learning theories are a
means of clarifying how people come to know, perceive, remember, use judgment and logic
(Strauch & Omar, 2014).
Behaviorism operates around the idea that all behaviors are in response to external
stimuli, and behavior is explainable without consideration of internal factors. Proposed by
theorists such as Skinner, Pavlov and Thorndike, behaviorists state that positive or negative
rewards will reinforce future behavior, but the learner is passive. Learning is simply defined as
behavior change (
Behaviorism may be utilized in nursing. For example, a nurse responds to an emergency,
but a negative outcome occurs. The nurse will respond differently next time. In the classroom, a
student takes a test and receives the negative feedback of a poor score, then makes a behavior
change to earn a passing grade on a subsequent test. Lecture is an example of a behavioral
learning technique. Thorndike believed teachers should present information right before it would
be useful (Pettigrew, 2015). An ideal time to lecture would be shortly before a test or before
exposure in the clinical setting.
In the positive, Behaviorism is relatively easy to apply, reinforcing the desired effect.
Unfortunately, with Behaviorism there is no certain way to determine when students will be

ready to learn, and it is not always possible to pinpoint when information will be used.
Behaviorism also does not take into consideration any external factors that affect learning.
In Cognitivism, the mind is much like a computer, and the learners behavior is changed
according to what is going on inside as an outcome of thinking ( It is a pure scientific approach to learning, with many research
studies to back up the theory (McLeod, 2015). Cognitivism focuses on the learner and uses their
growth to evaluate the teaching process (Pettigrew, 2015).
James Jude Vinales refers to the learning environment as an essential and irreplaceable
resource in which practitioners can prepare student nurses for their role as professionals (Vinales,
2015). Cognitivism techniques could be seen with an instructor testing students memory of
normal lab values. The theory lends itself to research, and an ideal use for Cognitivism would be
in experimental research to test memory. A positive point is that Cognitivism can be studied,
measured and researched. A drawback is that Cognitivism is not concerned with external factors
or the environment.
Social Cognitivism is an expansion of Cognitivism where the learner and environment
are in a relationship with one influencing the other (Pettigrew, 2015). The learning environment
includes social interaction as well as cultural influences. Knowledge is obtained by observing
the behavior of other people, consequences are recognized and these guide the individuals future
behavior. We replicate what we see others do (
Learning is an ongoing play between thought, behavior and environmental circumstances or
social context (Denler, Wolters & Benzon, 2014). Reciprocal teaching, where the instructor and
students work together to learn, with the teacher doing less and students being more responsible
for the learning is an example of social cognitivism.

Through Social Cognitivism, students should be provided frequent modeling of the

knowledge, skills, and behaviors they are expected to learn. This can be seen in the principles of
asepsis, beginning with proper hand washing, and proceeding to an understanding of sterile and
unsterile so that later they are able to understand the process of applying a sterile wound
dressing. Principles are discussed in the classroom, and then demonstrated in the clinical setting.
A great aspect of Social Cognitivism is that it allows for the development of cultural
competency. Cultural competence is essential to providing quality care. Cultural competence
encompasses the capacity to identify, understand, and respect the values and beliefs of others.
Nurses want to interact and care for those of other cultures, race, ethnicity, gender, religion, age,
sexual orientation, mental capacity, etc. (Diaz, Clark & Gatua, 2015). In the negative, although
there is always a learning environment present, the environment may not always have a positive
impact on the learner. The instructor has the largest impact on the learning environment for they
are the one who essentially creates it. An instructor who is distant, lacking in knowledge or
expertise, or one who is unapproachable will not have successful students (Vinales, 2015).
In the Humanistic theory, learning occurs as the result of actions based on perceived
needs. Proponents, Maslow and Rogers, believed that actions were motivated by goal
attainment. Maslows Hierarchy of Needs considered the learner needs, from basic
physiological to highly evolved self-actualization. Additionally, Rogers proposed that all
people could achieve their goals, and that self-actualization occurred after that (Pettigrew, 2015).
Humanistic teaching methods are personalized and the instructor acts primarily as a
facilitator ( An instructor utilizing this method might
provide students with additional learning resources, or facilitate in-class discussion that is
primarily student lead. Humanistic teaching includes participatory and discovery methods in an

accepting environment (Pettigrew, 2015). An ideal situation for Humanism is in a laboratory

simulation, which is encouraging, when compared to the clinical setting.
A downside to Humanism is that it could be difficult to find an accepting environment
that is encouraging to students. In a positive light, Humanism values personalization, which is
ideal for learning. Conversely, it is difficult to create personalized learning for every individual
in a large class. Humanistic learners are driven by goal attainment, and the desire to learn comes
from within the learner.
Constructivism defines learning as an internal process built on previous learning
(Pettigrew, 2015). Constructivisms central idea is that human learning is constructed and
learners build new knowledge upon the foundation of previous learning (Hoover, 1996). Prior
knowledge influences new or modified knowledge (Jones & Brader-Araje, 2002). Learning is
like building up a wall, brick by brick. Students are information constructor(s) (
In the positive, Constructivism focuses on students working in groups, sharing ideas peerto-peer, leading to meaningful knowledge, as in the group work done in Masters in Nursing
Education programs. Constructivism was deemed to havehadthegreatestimpactoninstruction
educationalapproaches(Jones&BraderAraje,2002,para.4).Limitations in Constructivism
would be seen if the teacher is unable to make the leap from telling to guiding learners in their
knowledge acquisition (Airasian & Walsh, 1997).
In Brain-based Learning instructors base their teaching designs and methods on the
latest scientific research regarding how the brain learns, including cognitive development, age,
growth, social maturation and emotions. Recent discoveries in cognitive science have revealed

that the human brain physically changes when it learns, and after practicing certain skills it
becomes increasingly easy to continue learning and improving. Learning effectively
improves brain functioning, resiliency, and working intelligence (Brain-Based Learning,
2013). Thompson (2015) stated that when learning occurs, there is a change in the way the
brains synapses connect, and this can be enhanced by chemicals associated with emotion, such
as dopamine, serotonin and adrenalin. Thus the best learning occurs with emotional engagement
and practice.
With brain-based theory, teachers may play calming music to decrease stress, reduce the
amount of time spent lecturing, engage students in regular physical activity, or create
comfortable reading and study areas with bean bags or couches. These are unique and positive
approaches to learning. As a limitation, neuroscience is still a young field, with scientific
methods and technologies still being developed and tested (Brain-Based Learning, 2013). For
example, the use of a treadmill in the classroom may be a means of physical activity to stimulate
brain activity, but it is impractical in terms of space, has liabilities, and may also not be
financially feasible.
Behaviorism is the simplest theory with the learner responding to what is going on
around him. A stimulus leads to a response. Cognitivism focuses inward, with our brains
likened to computers, and learning can be measured and researched. Social Cognitivism pushes
outward to include other people and their behavior as a part of the learning process. Humanism
takes the learners personal goals into account, with the ultimate goal being self-actualization,
and the student guiding their own learning. Constructivism, like Humanism, has instructors
acting as a guide to learning and students working together, building upward with each new
experience as a brick of foundation. Brain-Based Learning looks at the science of the brain,

recognizes that actual physical changes take place with learning, and unique methods in our
learning environment, such as music, emotion, and comfort improve learning.
There is no perfect learning theory. Each theory has good components and in nursing
education, the best points of each theory should be used to help students with knowledge
acquisition for the best patient care outcomes. Educators will practice and teach students and
patients as they have learnedwith variety and recognition of uniqueness, and numerous options
to reach their health and educational goals.


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