HES 008 (Health Education)

STUDENT ACTIVITY SHEET

BS NURSING / FIRST YEAR
Session # 3

LESSON TITLE : Applying Learning Theories to

Healthcare Practice
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can:

1. Define the principal constructs of each learning theory.

2. Differentiate among the basic approaches to learning Materials: Hand-outs, Pen & Paper, Notebook
for each of the five psychological learning theories
3. Give example of applying each Psychological Theory
to changing the attitudes and behaviors of learners;
and
4. Outline alternative strategies for learning in a given
situation

5. Identify the differences and similarities in psychological

learning theories
6. Discuss how Neuroscience Research has contributed
to a better understanding of learning
7. Identify specific teaching strategies for Fitts and References: Bastable,S.(2019) Applying
Posner’s three stages of motor learning; and Learning Theories to Healthcare
8. Explain how different types of practice and feedback Practice,Chapter3, p.69,p.93, Nurse as Educator
variables in motor learning can be applied to teaching. 5th Edition

LESSON PREVIEW / REVIEW (5 minutes)

Be prepared for a short activity.

1. Watch a short video provided and take down notes.

2. After watching the video you will be given 3 minutes to reflect on the importance of Applying Learning Theories to
Healthcare Practice
3. Share your thoughts to the class.

MAIN LESSON (50 minutes)

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

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 • 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

• Also called association learning or classical/Pavlovian 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.

• Other respondent-conditioning concepts used in psychology and healthcare

Systematic desensitization
Stimulus generalization
Discrimination learning
Spontaneous recovery

RESPONDENT CONDITIONING MODEL OF LEARNING

BASIC MODEL OF LEARNING

Where: NS= Neutral Stimulus

UCS = Unconditioned Stimulus
UCR = Unconditioned Stimulus
CS = Conditioned Stimulus
CR = Conditioned Response

EXAMPLE

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 Offensive odors Queasy feeling
(UCS) (UCR)

Hospital + Offensive odors Queasy feeling

(NS) (UCS) (UCR)

Several pairings of Hospitals + Offensive odors Queasy feeling

Hospital Queasy feeling

(CS) (CR)

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
A. Positive reinforcement
B. Negative reinforcement (escape or avoidance conditioning)
• To decrease behavior
A. Nonreinforcement
B. Punishment

Cognitive Learning Theory

• Concepts: cognition, gestalt, perception, developmental stage, information-processing, 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.
• Perception is selective.

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.

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 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.

INFORMATION PROCESSING MODEL OF MEMORY

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 has significant consequences for their
attitudes and actions (attribution theory)

Cognitive-Emotional Perspective

Efforts to incorporate emotional considerations within a cognitive framework

Empathy and moral emotions in moral development and prosocial behavior
Memory storage and retrieval and decision making involves cognitive and emotional brain processing.
Emotional intelligence
Self-regulation

Social Learning Theory

• Concepts: role modeling, vicarious reinforcement, self-system, self-regulation

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 • To change behavior, utilize effective role models who are perceived to be rewarded, and work with the social
situation and the learner’s internal self-regulating 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 influence.

SOCIAL LEARNING THEORY

EXTERNAL PROCESSES INTERNAL PROCESSES EXTERNAL PROCESSES

Attentional Retention Reproduction Motivational Performance

Role model
Phase Phase Phase Phase
demonstrates
behavior, which
is perceived by
the learner to be Obsevation Processin Memory guides Influence by
reinforced of role g and performance of vicarious
(vicarious model represent model’s actions reinforcement
reinforcement); ation in and
model may memory punishment
facilitate or inhibit
learning a Covert
behavior cognitive
activity,
consequences
of behavior,
and self-
reinforcement
and
punishment

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.

• 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,
self-concept, and subjective feelings.
• Learning is facilitated by caring facilitators and a nurturing environment that encourage spontaneity, creativity,
emotional expression, and positive choices.

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 Humanist Dynamics
• Motivation: needs, desire to grow, self-concept
• 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

MASLOW’S HIERARCHY OF NEEDS

Self- Actualization
Need to fulfill one’s potential

Esteem
Need to be perceived as competent,
have confidence and independence,
and have status, recognition, and
appreciation

Belonging and love

Need to give and receive affection

Safety
Need for security, stability, structure,
and protection as well as freedom
from fear

Physiological
To have basic survival needs met
(food, water, warmth, sleep)

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 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.

SUMMARY OF LEARNING THEORIES

Humanistic Internal feelings about

self

Psychodynamic Internal forces e.g.development

Social Learning External Role Models

Cognitive Internal perception and thought processing

Environmental Stimulus conditions and

Behaviorist
reinforcement

Motor Learning

• Motor learning is useful in addition to theories of psychological learning.

• Examples of skills taught
• Walking with crutches
• 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, understanding of task goals, modeling/ demonstration

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 • Practice - Massed vs. distributed, variability, whole vs. part, random vs. blocked, guidance vs. discovery learning,
mental

PRACTICE AND FEEDBACK VARIABLES IN MOTOR LEARNING

Practice Variables in Motor Learning

● Massed Practice
● Distributed Practice
● Variability of Practice
● Whole-tasked practice
● Part-task practice
● Random practice
● Blocked practice
● Guidance practice/learning
● Discovery practice/learning
● Mental practice

Feedback Variables in Motor Learning

● Intrinsic (inherent) feedback
● Extrinsic (augmented or enhanced) feedback
● Knowledge of results (KR) feedback
● Knowledge of performance (KP) feedback
● Continuous feedback
● Intermittent feedback
● Concurrent feedback
● Postresponse (terminal) feedback

● 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

• Knowledgeable educator
• Relate new information to learner’s past experiences

Learning Hindrances
• Ignoring common considerations may hinder learning.
• Other learning hindrances
• Lack of clarity and meaningfulness to what is being learned
• Fear, neglect, or harsh punishment
• Negative or ineffective role models

• Other learning hindrances (cont’d)

• Inappropriate materials for learner’s ability, readiness to learn, or stage of development
• Detrimental socialization experiences
• Nonstimulating environment
• Lack of goals or realistic expectations

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 Making Learning Permanent

• Enhance the likelihood of learning

1. Organize the learning experience.
2. Make learning experiences meaningful and pleasurable.
3. Recognize the role of emotions in learning.
4. Pace the teaching session appropriately with the learner’s ability to process information

• Practice new knowledge or skills (mentally and physically) under varied conditions.
• Learner may need incentives and rewards but not always.
• Assess and evaluate learner on skills soon after session as well as at later times to evaluate knowledge transfer.

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

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. 1 point will be given to every correct
answer and another 1 point for correct rationalization. You have 30 minutes to do this.

Multiple Choice
1. A person’s knowledge may not necessarily reflect reality, but through collaboration and negotiation, new understanding
is acquired.
A. Respondent Conditioning
B. Social Constructivist Perspective
C. Gestalt Perspective
D. Operant Conditioning

Answer: B
Rationale: 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.

2. A learning that occurs as the organism responds to stimuli in the environment and is reinforced for making a
particular response.
A. Respondent Conditioning
B. Social Constructivist Perspective
C. Gestalt Perspective
D. Operant Conditioning

Answer: D
Rationale: 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 condition.

3. A Perception and the patterning of stimuli are the keys to learning, with each learner perceiving, interpreting, and
reorganizing experiences in her/his own way.
A. Respondent Conditioning
B. Social Constructivist Perspective
C. Gestalt Perspective
D. Operant Conditioning

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 Answer: C
Rationale: 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. Perception is selective.

4. Also called association learning or classical/Pavlovian conditioning where learning occurs as the organism
responds to stimulus conditions and forms associations.
A. Respondent Conditioning
B. Social Constructivist Perspective
C. Gestalt Perspective
D. Operant Conditioning

Answer: A
Rationale: Also called "association learning" or "classical/Pavlovian conditioning." Learning occurs as the organism
responds to stimulus conditions and forms associations. It is a neutral stimulus that is paired with an unconditioned
stimulus–unconditioned response connection until the neutral stimulus becomes a conditioned stimulus that elicits
the conditioned response.

5. A phase in the Social Learning Theory that is influenced by vicarious reinforcement and punishment
A. Motivational
B. Attentional
C. Retention
D. Reproduction

Answer: A
Rationale: Influence by vicarious reinforcement and punishment. Covert cognitive activity, consequences of behavior, and
self-reinforcement and punishment.

RATIONALIZATION ACTIVITY
Identify the following terms and give their motivation:
Keywords Motivation
1. Intrinsic feedback Inherent Sensory/perceptual information with
movement
2. Neuroscience Thinking, learning, & behavior Stress and learning

3. Autonomous motor Automatic, advanced level Attention, goal-setting, etc.

4. Psychodynamic Personality development Libido

5. Humanistic Desire to grow in positive ways Derived from needs

LESSON WRAP-UP (5 minutes)

You will now mark the session you have finished today in the tracker below.This is only a visual to help you track how
much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

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 CAT 3-2-1 / EXIT TICKET/PASS
1. You will record three things you learned from the lesson.

 I learned about the principal constructs of each learning theory.

 I can now identify the differences and similarities in psychological learning theories.
 I can identify the specific teaching strategies for Fitts and Posner’s three stages of motor learning.

2. Also, record two things that you found interesting about the topic

 I am interested in learning the Psychological Theory.

 Learning on how to handle attitudes and behaviors.

3. One question
 Do all nurses can handle psychological problems?

END NOTE: The instructor will inform the students of the topic for the next Session Determinants of Learning

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