CHAPTER 4: Determinants of Learning

Three determinants of 1. Learning needs—what the learner needs and wants to learn.
learning 2. Readiness to learn —when the learner is receptive to learning.
3. Learning style —how the learner best learns.

Learning needs defined as gaps in knowledge that exist between a desired level of performance and
the actual level of performance
(HealthCare Education Associates, 1989).

Important steps in the 1. Identify the learner

assessment of learning 2. Choose the right setting
needs 3. Collect data about the learner.
4. Collect data from the learner
5. Involve members of the healthcare team.
6. Prioritize needs.
7. Determine availability of educational resources.
8. Assess the demands of the organization.
9. Take time-management issues into account.

Criteria for Prioritizing  Mandatory: Needs that must be learned for survival or situations in which the
Learning Needs learner’s life or safety is threatened.
 Desirable: Needs that are not life dependent but that are related to well-being
or the overall ability to provide high-quality care in situations involving
changes in institutional procedure.
 Possible: Needs for information that is nice to know but not essential or
required or situations in which the learning need is not directly related to daily
activities.

Methods to Assess  Informal Conversations

Learning Needs  Structured Interviews
 Focus Groups
 Questionnaires
 Tests
 Observations
 Documentation
Assessing the Learning Williams (1998) specifically addresses the importance of identifying the learning needs of staff
Needs nurses using the methods described in this section.
of Nursing Staff  Written Job Descriptions
 Formal and Informal Requests
 Quality Assurance Reports
 Chart Audits
 Rules and Regulations
 Self-Assessment

Gap Analysis - organized method to identify differences between desired and actual knowledge.
- Data gathered are then used to determine what differences exist that will need an
education intervention.

Delphi Technique is a structured process using a series of questionnaires

or rounds that provides information about the
specific need(s).
Readiness to Learn - defined as the time when the learner demonstrates an interest in learning the
information necessary to maintain optimal health or to become more skillful in a job.
- when a patient, staff member, or student asks a question, the time is prime for
learning.

PEEK Physical Readiness

 Measures of ability
 Complexity of task
 Environmental effects
 Health status
 Gender

Emotional Readiness
 Anxiety level
 Support system – reachable moment
 Motivation
 Risk-taking behavior
 Frame of mind
 Developmental stage – teachable moment

Experiential Readiness
 Level of aspiration
 Past coping mechanisms
 Cultural background
 Locus of control
- Internal locus of control; that is, they are ready to learn when they feel a
need to know about something.
- External locus of control; that is, they are externally motivated—then
someone other than themselves must encourage the learner to want to know
something.

Knowledge Readiness
 Present knowledge base
 Cognitive ability
 Learning disabilities
 Learning styles

Learning styles refer to the ways in which and

conditions under which learners most efficiently
and most effectively perceive, process, store, and
recall what they are attempting to learn (James &
Gardner, 1995) and their preferred approaches to
different learning tasks

Three mechanisms to - observation

determine learning style - interviews
- administration of learning style instruments

Learning Style Models

and Instruments:
Right-Brain/Left-Brain and not technically a model, right-brain/left-brain thinking, along with whole-brain thinking, adds to
Whole-Brain Thinking the understanding of brain functions that are associated with learning.
Left-Hemisphere Functions ■ Thinking is critical, logical, convergent,
focal
■ Analytical
■ Prefers talking and writing
■ Responds to verbal instructions and
explanations
■ Recognizes/remembers names
■ Relies on language in thinking and
remembering
■ Solves problems by breaking them into
parts, then approaches the problem
sequentially, using logic
■ Good organizational skills, neat
■ Likes stability, willing to adhere
to rules
■ Conscious of time and schedules
■ Algebra is the preferred math
■ Not as good at interpreting body
language
■ Controls emotions

Right-Hemisphere ■ Thinking is creative, intuitive, divergent,

Functions diffuse
■ Synthesizing
■ Prefers drawing and manipulating
objects
■ Responds to written instructions and
explanations
■ Recognizes and remembers faces
■ Relies on images in thinking and
remembering
■ Solves problems by looking at the whole
and the configurations, then approaches
the problem through patterns, using
hunches
■ Loose organizational skills, sloppy
■ Likes change, uncertainty
■ Frequently loses contact with time and
schedules
■ Geometry is the preferred math
■ Good at interpreting body language
■ Free with emotions
Instruments to Measure 1. Brain Preference Indicator (BPI)
Right-Brain/Left-Brain and  general style of thought that results in a consistent pattern of behavior in all
Whole-Brain Thinking areas of the individual’s life.
 Although the reliability and validity of this instrument have not been
reported.
 Whole-Brain Thinking by Wonder and Donovan (1984).

2. Herrmann Brain Dominance Instrument (HBDI)

 4 modes:
 Quadrant A (left brain, cerebral): logical, analytical, quantitative,
factual, critical
 Quadrant B (left brain, limbic): sequential, organized, planned,
detailed, structured

Field-Independent/Field-
Dependent Perception
Field-Independent
Learners
Field-Dependent Learners
instrument to Measure
Field Independence/Field
Dependence
Dunn and Dunn Learning
Styles
Five basic stimuli that
affect a person’s ability to
learn:
 Quadrant C (right brain, limbic): emotional, interpersonal, sensory,
kinesthetic, symbolic
 Quadrant D (right brain, cerebral): visual, holistic, innovative
An extensive series of studies by Witkin, Oltman, Raskin, and Karp (1971b) identified two styles
of learning in the cognitive domain, which are based on the bipolar distribution of
characteristics of how learners process and structure information in their environment.
■ Are not affected by criticism
■ Will not conform to peer pressure
■ Are less influenced by external feedback
■ Learn best by organizing their own material
■ Have an impersonal orientation to the world
■ Place emphasis on applying principles
■ Are interested in new ideas or concepts
for own sake
■ Provide self-directed goals, objectives, and
reinforcement
■ Prefer lecture method
■ Are easily affected by criticism
■ Will conform to peer pressure
■ Are influenced by feedback (grades and
evaluations)
■ Learn best when material is organized
■ Have a social orientation to the world
■ Place emphasis on facts
■ Prefer learning to be relevant to own
experience
■ Need external goals, objectives, and
reinforcements
■ Prefer discussion method.
Group Embedded Figures Test (GEFT)
- 30 minutes
- find simple geometric figures within complex drawings.
In 1967, Rita Dunn and Kenneth Dunn set out
to develop a user-friendly model that would
assist educators in identifying characteristics
that allow individuals to learn in different ways
1. Environmental elements
2. Emotional elements
3. Sociological patterns
4. Physical elements
5. Psychological elements
Instrument to Measure Productivity Environmental Preference Survey (PEPS)
the
Dunn and Dunn Learning - It indicates how people prefer to learn, not the abilities they possess.
Style
Inventory
Jung and Myers–Briggs 1. Carl G. Jung (1921/1971)
Typology - Swiss psychiatrist
- developed a theory that explains personality similarities and differences by
identifying attitudes of people (extraverts and introverts) along with opposite
mental functions, which are the ways people perceive or prefer to take in and
make use of information from the world around them.

- word type to identify these styles of personality.

2. Isabel Myers & Katherine Briggs,

-became convinced that Jung’s theories had an application for increasing human
understanding.

- 16 personality types, based on four constructs:

1. Extraversion–Introversion (E–I)
2. Sensing–Intuition (S–N)
3. Thinking–Feeling (T–F)
4. Judging–Perceiving (J–P)
Instrument to Measure Myers–Briggs Type Indicator (MBTI)
the - permits people to learn about their own type of behavior and understand
Myers–Briggs Personality themselves better with
Types respect to the way in which they interact with others.

- not a learning style instrument per se, it is a forced-choice, self-report

inventory

Kolb’s Experiential - known as the cycle of learning, includes four modes of learning that reflect two
Learning major dimensions: perception and processing.
Mode
 David Kolb (1984),
- a management expert from Case Western Reserve University, developed his
learning style model in the early 1970s.
- knowledge is acquired through a transformational process, which is
continuously created and recreated.
- learner is not a blank slate but rather approaches a topic to be learned with
preconceived ideas.

Instrument to Measure  Learning Style Inventory (LSI)

Kolb’s - 20-item,
Experiential Learning - self-report questionnaire that requires respondents to rank four sentence
Styles endings corresponding to each of the four learning modes
4MAT System McCarthy (1981)
- developed a model based on previous research on learning styles and brain
functioning.

- she used Kolb’s model combined with Sperry’s right-brain/left-brain research

findings to create the 4MAT system.
Four Types of Learners  Type 1/Imaginative:
Learners who demand to know why. These learners like to listen, speak,
interact, and brainstorm.

 Type 2/Analytical:
Learners who want to know what to learn. These learners are most comfortable
observing, analyzing, classifying, and theorizing

 Type 3/Common sense:

Learners who want to know how to apply the new learning. These learners are
happiest when experimenting, manipulating, improving, and tinkering.

 Type 4/Dynamic:
Learners who ask, What if? These learners enjoy modifying, adapting, taking
risks, and creating.
Instrument to Measure  26-point questionnaire
the 4MAT
System  no direct criticism of the 4MAT model, and it is accepted by many educators as
a useful approach for presenting new information.
Gardner’s Eight Types of Psychologist Howard Gardner (1983)
Intelligence - developed a theory focused on the multiple kinds of intelligence in children.
- Existential:
this kind of intelligence individuals seem to possess the ability to contemplate
phenomena or questions beyond sensory data.

1. Linguistic intelligence - reside in Broca’s area of the left side of the brain.

- Children with a tendency to display this type of intelligence have highly developed
auditory skills and think in words.
2. Logical-mathematical - involves both sides of the brain.
intelligence - The right side of the brain deals with concepts, and the left side remembers symbols.
- The children who are strong in this intelligence explore patterns, categories, and
relationships.
3.Spatial intelligence - related to the right side of the brain.

- Children with high spatial intelligence learn by images and pictures.

4. Musical intelligence - right side of the brain.
- Musically intelligent children can be found singing a tune, indicating when a note is off
key, playing musical instruments with ease, dancing to music, and keeping time
rhythmically.
5.Bodily-kinesthetic - basal ganglia and cerebellum of the brain in addition to other brain structures.
intelligence - Children with this type of intelligence learn by processing knowledge through bodily
sensations, such as moving around
or acting things out.
- It is difficult for these learners to sit still for long periods of time. They are good at
sports and have highly developed fine-motor coordination.
6. Interpersonal - Pre-frontal lobes of the brain.
intelligence - Children with high interpersonal intelligence understand people, notice others’ feelings,
tend to have many friends,
and are gifted in social skills.
-
7. Intrapersonal
intelligence
8. Naturalistic intelligence
Instrument to Measure
Multiple
Intelligence
VARK Learning Styles
Instrument to Measure
the VARK
State of the Evidence
- Children with this type of intelligence have strong personalities, prefer the inner
world of feelings and ideas, and like being alone
- They are very private individuals, desire a quiet area to learn, and prefer to be
by themselves to learn
- refers to sensing abilities in making patterns and connections to elements in nature.
- Children with high naturalistic intelligence can distinguish and categorize objects or
phenomena in nature
Multiple Intelligences Developmental Assessment Scales (MIDAS™)
- created by C. Branton Shearer (http://www.miresearch.org/)
Fleming and Mills (1992)
- technically focuses on a person’s preference for taking in and putting out
information
- have identified four categories or preferences:
V isual
A ural
R ead/write
K inesthetic
VARK questionnaire (version 7.8)
- 16 questions with four options or modalities, and the learner can select more
than one option for each question.
Lohr (2004).
- She cites four dimensions of evidence that nurse educators need to consider
when assessing the available evidence:
1. Level of evidence (study design).
2. Quality of evidence (concern with bias).
3. Relevance of evidence (implying applicability)
4. Strength of evidence (precision, reproducibility, and attributability)