Applying Theories

of Learning to
Health Care Practice

M.Q.Espiritu,RN,MAN
M.Q.Espiritu,RN,MAN
 Nature of the Learner
Human development- dynamic process of
change that occurs in the physical,
psychological, social, spiritual, and
emotional constitution and make-up of an
individual which starts from the time of
conception to death ( from womb to tomb).
Scientific study of the changes that occur in
people as they age or grow older in years.

M.Q.Espiritu,RN,MAN
 Nature of the Learner
Changes:
1. Growth- quantitative involving increase
in the size of the parts of the body;
2. Development – qualitative involving
gradual changes in character

M.Q.Espiritu,RN,MAN
 Nature of the Learner
Person grows and develops: Two major
processes:
1. Learning – permanent change in
behavior as a result of experience w/c
is primarily determined or influenced
by the environment where the person
is situated.
-

M.Q.Espiritu,RN,MAN
 Nature of the Learner
Learning - complex process- changes in
mental processing, development of
emotional functioning and social
transactional skills which develop and
evolve from birth to death.

M.Q.Espiritu,RN,MAN
 Nature of the Learner
Note: Learning theories, teaching and
learning techniques and strategies
based on scientific studies and
principles and assessment and
evaluation techniques have been given
more emphasis in what is now the trend of
“mentoring the mentor” or “training the
trainer”.

M.Q.Espiritu,RN,MAN
 Nature of the Learner
2. Maturation- bodily changes; heredity or
the traits that a person inherits from his
parents which are genetically
determined.
- preprogrammed inherited biological
patterns are reflected in maturation.

M.Q.Espiritu,RN,MAN
 Factors influencing
Intellectual Development
1. Maturation- biological changes in
individuals that results from interaction
of their genetic makeup with the
environment.
2. Experience – observing, encountering or
undergoing changes of individuals which
generally occur in the course of time.

M.Q.Espiritu,RN,MAN
 Factors influencing
Intellectual Development
3. Learning – acquisition, abilities, habits,
attitudes, values and skills derived from
experiences with varied stimuli.
- product of experiences and goals of
education where students are trained to
profess further development.

M.Q.Espiritu,RN,MAN
 Factors influencing
Intellectual Development
( Adapted from Educational Psychology
Classroom Connections; 2nd edition)

Experience Learning Maturation

Development

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
1. Prenatal development- time from
conception to birth from a single cell to
an organism complete with brain and
behavioral capabilities produced in
9months (270-280 days or 40weeks).
Heredity – sum total of characteristics w/c
are biological transmitted thru parents to
offspring. Genes- made up of DNA
(hereditary characteristics).
M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Two types of Cells in the human body:
a. body or somatic cells- concerned with
the development of the different parts of
the body.
b. germ or reproductive cells- concerned
with heredity.
Note: human cell nucleus (46 chromosomes;
23 from mother and 23 from father

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development:
The female egg contains an X
chromosomes and every sperm cell
contains either an X or Y chromosomes;
XX= female offsring
XY= male offspring
Chromosomes- found in the nucleus of
each cell w/c contains the genes.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
2. Infancy- Sensorimotor stage/ practical
intelligence birth up to18 or 24months.
- time of extreme dependence on
adults
- babyhood
- beginning of many psychological
activities; like language, symbolic
thoughts, sensorimotor
coordination and social learning.
M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Sensorimotor development:
- head turns to direction of touch,
- lifts chin and head,
- holds head erect,
- reaches for objects,
- sits with support,
- stands with help,
- crawls and walks with support.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
3. Toddler: Early Childhood- end of infancy to
about 5-6 years; pre-school years.
- more self-sufficient and care for
themselves.
- develop school readiness skills;
letters and following instructions.
- play with peers
Pre- school experiences affects G & D:
- develops a healthy and pleasant
personality.
M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Early Childhood:
- learns to communicate and develop
understanding of himself and his
environment
- quality of interaction between the child
and parents- affects the child’s own
attitude.
- relationship to significant others;
grandparents, uncles and aunties, those
with constant touch and contact.
M.Q.Espiritu,RN,MAN
Toddler: (1-3years)
a. Pre-conceptual stage– perceptual
dominance- child who can classify
objects into toys and non-toys
b. preoperational Stage – incomplete
stage.
- language development, formulate a
number of concrete concepts.
- egocentrism- self centered.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
4. Middle and late Childhood- 6 to 11years
(elementary school year).
- fundamental skills of reading, writing
and arithmetic are mastered
- child is formally exposed to the
world and culture
- more achievement centered with
increased self-control.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
5. Adolescence- transition to early
adulthood
- from 10-12 years and ends at
18-22 years old.
- pubertal growth spurt; marked by
rapid gains in height and weight
and changes in body contour.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Puberty – marked development of sexual
characteristics (breast enlargement,
development of pubic and facial
hair, deepening of the voice),
production of sex hormones and
physical capability of reproduction,
onset of menarche or menstruation.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Adolescence:
- pursuit of independence and an
identity is prominent.
- thoughts are more logical, abstract
and idealistic
- more time is spent outside the family
- early adolescence- from 13 up to 16 or
years
- late adolescence- from 16 to 18 up to 21
years old.
M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Adolescence: Developmental tasks
- developing independence in
preparation for adulthood
- establishing a sense of identity
Physical aspect of development
- more marked internal than external
development during later adolescence
- spends more time with the physical
looks and improving appearance.
M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
Adolescence:
Role of significant others:
- like parents and teachers can help a
lot to cushion the impact of the
teenager’s “growing-up pains”.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
6. Early Adulthood- begins in late teens or
early twenties thirties.
- establishing personal and economic
independence
- career development
- selecting a mate
- intimate relationships
- starting a family

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
7. Middle Adulthood – from 35-45 old up to
65 years old.
- menopause for women
- climacteric or andropause for men
- time of expanding personal and
social involvement and
responsibility; of assisting next
generation in becoming competent.

M.Q.Espiritu,RN,MAN
Periods of Lifespan Development
8. Late Adulthood or Senescence- from 65
to 80 years
- time of adjustment to decreasing
strength and health
-life review
- retirement
- adjustment to new social roles
- affiliations with members of one’s
age group
M.Q.Espiritu,RN,MAN
 Assignment:
Four Theories of Human Development
I. Theory of Psychosexual Development
II. Erickson’s Psychosocial Stages of
Development
III. Piaget’s Theory of Cognitive
Development
IV. Moral development Theory by
Lawrence Kohlberg
Note: Give your perspective in every theory; 10points
each.
- handwritten and use yellow pad.
 Included in Midterm Examination…

M.Q.Espiritu,RN,MAN
 Determinants of Learning
Haggard (1989); Educator’s role- primarily assess the
learner in relation to the factors that affect
learning.
Factors;
1. learning needs- what the learner needs to learn
2. learning readiness- when the learner is receptive to
learning
3. learning style- how the learner best learns

M.Q.Espiritu,RN,MAN
 Determinants of Learning
I. Learning Needs:
- gaps in knowledge that exist between a
desired level of performance and the
actual level of performance (Healthcare
Education Association, 1985).
- gap or difference between what
someone knows and what someone
needs to know due to lack of
knowledge, attitudes or skills.
M.Q.Espiritu,RN,MAN
Determinants of Learning
Methods Used to Assess Learning Needs:
1. Informal Conversation or interviews- between the
nurse and the patient and or the family
members or other members of the health team;
- asking open-ended questions= reveal
information (perceived learning needs.
2. Structured interviews- pre-determined questions to
 gather information.
 - reveal uncertainties, anxieties, fear ,
 unexpected problems and present knowledge
 base.
M.Q.Espiritu,RN,MAN
Determinants of Learning
3. Written pretests- identify the knowledge level.
- help in evaluating by comparing pretest with
the post test.
4. Observation- health behaviors over a period of
times.
- determine established patterns of behavior
like observing how a watcher does a
procedure—
- assessing psychomotor need.

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
1. Intelligence
2. Multiple intelligence
3. emotional intelligence
4. Socioeconomic status
5. culture
6. gender differences
At-risk students

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
A. Intelligence- individual’s capacity to acquire
knowledge, ability to think, abstract reasoning
and capability in problem solving (Fieldman:2004)
a. determined by genetic and environment
b. measured based on the results of intelligence
tests or aptitude tests
c. students with high aptitude need less time and
less instructional support.

M.Q.Espiritu,RN,MAN
Teacher: adjust and adapt instructional
approaches considering the differences in
students’ ability (Chiatum and Hammond:
2005).
1. Flexible time requirement- equate with the
students’ rate of growth and their
readiness to learn.
- design extra activities; free reading
time, RLE, computer activities and
other self enhancing activities.
M.Q.Espiritu,RN,MAN
2. Increased Instructional support
- approach must be adjusted to students’ needs
for learning
- support of fast learners- peer tutoring and grp
activities.
- clarify and expand explanation
- assignments- shorter segments
- frequent feedback
3. strategy instruction- research; ana;lyze and
break down tasks.

M.Q.Espiritu,RN,MAN
4. Peer tutoring- serve as sources of information
for less able students.
5. Cooperative learning- skills in skill
demonstrations
Student tutors are able to enhance their social
skills during cooperative learning activities.

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
B. Multiple Intelligence:
The theory of multiple intelligences was
developed in 1983 by Dr. Howard Gardner,
professor of education at Harvard University. It
suggests that the traditional notion of intelligence.

M.Q.Espiritu,RN,MAN
Eight different intelligences
Linguistic intelligence (“word smart”)
Logical-mathematical
intelligence (“number/reasoning smart”)
Spatial intelligence (“picture smart”)
Bodily-Kinesthetic intelligence (“body smart”)
Musical intelligence (“music smart”)
Interpersonal intelligence (“people smart”)
Intrapersonal intelligence (“self smart”)
Naturalist intelligence (“nature smart”)

M.Q.Espiritu,RN,MAN
Howard Gardener described 9 types of intelligence;1983:

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
C. Emotional Intelligence- combinations of
competencies.
- skills contribute to an individual’s
capability to manage and monitor his or her
own emotions, to correctly gauge the
emotional state of others and to influence
opinions.

M.Q.Espiritu,RN,MAN
M.Q.Espiritu,RN,MAN
Five Dimensions of Emotional Intelligence
1. Self-awareness- ability to recognize one’s
feeling as this happens, to accurately
perform self-assessment and have
confidence.

M.Q.Espiritu,RN,MAN
 Five Dimensions of Emotional
Intelligence
2. Self-management/ self-regulation:
 a. ability to keep disruptive emotions and
impulses in check (self-control)
b. maintain standards of honesty and integrity
(trustworthiness),
c. responsibility for one’s performance
(conscientiousness),
d. handle change – adaptability
e. comfortable with novel ideas and approaches
(innovations)
M.Q.Espiritu,RN,MAN
 Five Dimensions of Emotional
Intelligence
3. Motivation- emotional tendency of guiding
or facilitating the attainment of goals through;
a. achievement drive to meet a standard of
excellence
b. commitment or the alignment of goals with
the group or organization
c. initiative to act on opportunities
d. optimism or the persistence to reach goals
despite setbacks
M.Q.Espiritu,RN,MAN
Five Dimensions of Emotional
Intelligence
4. Empathy- understanding of others by
being aware of their needs, perspectives,
feelings, concerns and sensing others
developmental needs.

M.Q.Espiritu,RN,MAN
 Five Dimensions of Emotional
Intelligence
5. Social skills- fundamental to emotional
intelligence;
- influence- the ability to induce desirable
responses in others through effective
diplomacy of persuading.
- communication- ability to both listen
openly and send convincing messages.

M.Q.Espiritu,RN,MAN
Social skills:
- leadership- ability to inspire and guide
groups and individuals
- building bonds- nurturing instrumental
relationships
- collaboration and cooperation with
others toward a shared goal.
- create group synergy- ability to pursue
collective goals.
M.Q.Espiritu,RN,MAN
M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
D. Socioeconomic Status (SES) - is a
measure of a family ‘s position in society as
determined by family income, its member’s
occupation, and level of education.
-Poverty affects a learner’s well-being and
quality of life.
- turn affects the student’s concentration,
learning potentials, motivation, interests and
participation in class
M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
E. Culture- refers to attitudes, values
customs and behavior patterns that
characterize a social group.
- influences school success, through the
students’ attitudes and values and ways
of viewing the world that are held and
transmitted by a culture. (Brecken:1994).

M.Q.Espiritu,RN,MAN
Culture influences the following:
1. Students’ Attitudes and Values
 To become a good student, one must
be able to adopt to culture values imposed
by the school as a learning institution.
 based on its mission, vision, objectives and
goals whether it is secular or non-secular
institution.

M.Q.Espiritu,RN,MAN
 Socio-
Intelligence econimoc
Status

Learner
Individuality

Gender Culture

M.Q.Espiritu,RN,MAN
Culture influences the following
2. Classroom Organization
- students work and learn individually.
- Emphasis is placed on individual
responsibility, which is often reinforced by
grades and competition.
- Competition demands both successes
and failures, and the success of the one
students is tied to the failure of another.
M.Q.Espiritu,RN,MAN
Culture influences the following
3. School Communication
- cultural conflict in communication
may occur in an institution with students
from diverse ethnicities.
- may not always have the same meaning
to another students of a different ethnicity.

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
F. Gender Differences
1. Different Treatment of Boys and Girls
- male and female babies are treated
differently.
- girl is handle more delicately while a
baby boy is seen as tougher and more
hardy.

M.Q.Espiritu,RN,MAN
 Gender differences
2. Stereotyping Boys and Girls
This gender-based treatment extends up
to the child’s school year.
- Males are consider better in
Mathematics while females are better in
English.

M.Q.Espiritu,RN,MAN
Categories of learners according to
individual differences
G. At-Risk Students
- At-risk students are those in danger of
failing to complete their education.
- learning problems and adjustments
difficulties.
- often fail even though they have the
capability to succeed.

M.Q.Espiritu,RN,MAN
LEARNING NEEDS BASED ON MASLOW’S
HIERARCHY OF NEEDS
Maslow’s hierarchy of needs is divided
into two (2) categories. (Simon: 1987):
1. Deficiency needs- whose absence
energizers or moves people to meet them.
Until a lower need is met, an individual is
unlikely to move to a higher need

M.Q.Espiritu,RN,MAN
2. Growth needs- are needs “met”, as they
expand and grow as people have
experiences with them.
- require people to indulge in activities
that are physically and psychologically
and enhance strength and vigor to
proceed to a higher level task

M.Q.Espiritu,RN,MAN
 Implications of the Hierarchy of Needs to Education
1. Impoverished students who are unable to meet their
basic need such as food and enough rest tend to have
diminished motivation to learn
2. Students who have a low sense of security tend to
achieve less than those who have a high sense of
security.
3. Growth needs energize and direct student learning
4. True motivation for learning develops only when
students see the relationship between what they are
learning and their primary goals on rewards and
punishments
M.Q.Espiritu,RN,MAN
 OTHER LEARNING NEEDS
A. The Need for Competence
1. Competence motivation is an innate need
in human beings
2. Competence motivation creates drive in
oneself to master tasks and enhance skills
3. Competence motivation is essential in
coping with the fast changing environment

M.Q.Espiritu,RN,MAN
 G
D R
E O
F W
MASLOW’S HIERARCHY OF NEEDS
I T
C H
I Intellectual achievement
E N (knowing and understanding)
N E
C E Self-esteem
Y D (recognition and approval)
S
N
Belonging
E
(love and acceptance from family and peers)
E
D
S Safety
(freedom from emotional and physical treat)

Survival
(shelter, warmth, food, water)

M.Q.Espiritu,RN,MAN
 OTHER LEARNING NEEDS
B. The Need for Control and Self-Determination
1. As stated in the Bible, man is a steward to God’s
creation. Hence, there is need of control.
2. Man continuously strives for competence and
autonomy.
3. Teachers may satisfy a student’s need for control
by encouraging inputs such as opinions
suggestions and criticism among others, during
class lectures and discussions

M.Q.Espiritu,RN,MAN
 OTHER LEARNING NEEDS
C. The Need to Achieve
1. Achievement motivation is the drive ton
excel in learning tasks to experience pride
in accomplishment
2. The need to achieve is balanced by the
need to avoid failure
3. Students with high need to avoid failure
then to avoid challenging tasks

M.Q.Espiritu,RN,MAN
4. Students with high need for achievement
tend to be motivated by challenging
assignments, high grading standards,
explicit feedback and the opportunity to
try to face challenges in life.
5. Students who do not want to fail, are
motivated by simple assignments, liberal
grading, and protection from
embarrassment due to failure.
M.Q.Espiritu,RN,MAN
 Steps in the assessment of
Learning Needs
1. Identify the learner – who is the learner?
2. Choose the right setting- trusting
environment by ensuring privacy and
confidentiality.
3. Collect data on the learner- characteristics
of learning needs
4. Include the learner as a source of
information- allow to actively participate
in identifying his needs and problems.
M.Q.Espiritu,RN,MAN
 Steps in the assessment of
Learning Needs
5. Include members of the healthcare team-
- collaborate with the other healthcare
professionals; insight of knowledge
6. Determine availability of educational
resources – materials and equipment that
will be used to demonstrate procedures
(appropriate, available, affordable, easy
and simple to manipulate).
M.Q.Espiritu,RN,MAN
 Steps in the assessment of
Learning Needs
7. Assess demands of the organization-
examine the organizational climate,
philosophy, vision and mission and goals to
know what its educational focus.
8. Consider time-management issues- allow
learners to identify their learning needs;
identify potential opportunities to assess the
patient anytime, anywhere and minimize
distractions.
M.Q.Espiritu,RN,MAN
 Steps in the assessment of
Learning Needs
9. Prioritize needs- Maslow’s hierarchy of
needs.

M.Q.Espiritu,RN,MAN
Steps in the assessment of
Learning Needs

M.Q.Espiritu,RN,MAN
 Criteria for prioritizing
Learning needs
1. Mandatory- immediately met since they
are life threatening condition or are need
for survival. emergency measures (heart
attack, stroke)
2. Desirable- must be met to promote well-
being and are not life-dependent (PTB
cases)

M.Q.Espiritu,RN,MAN
 Criteria for prioritizing
Learning needs
3. Possible- “nice to know” learning needs
which are not directly related to daily
activities. Ex. Obese patient who just lost
weight because of her diabetes.

M.Q.Espiritu,RN,MAN
 Determinants of Learning
II: Readiness to Learn:
-is the time when the patient is
“willing to learn” or is receptive to
information.

M.Q.Espiritu,RN,MAN
Assessment: Readiness to learn
1. determine what needs to be taught
2. find out exactly when the learner is ready
to learn
3. discover what the patient wants to learn
4. identify what is required of the learner
5 determine if the timing is right or proper
6. find out if rapport or interpersonal
relationship with the learner has been
established
M.Q.Espiritu,RN,MAN
Assessment: Readiness to Learn
7. determine if the learner is showing signs
of motivation
8. assess if the plan for teaching matches
the developmental level of the learner.

M.Q.Espiritu,RN,MAN
Types of Readiness to learn
1. P- Physical readiness
2. E – Emotional readiness
3. E - Experimental readiness
4. K – Knowledge readiness

M.Q.Espiritu,RN,MAN
Types of Readiness to learn
A. Physical Readiness:
1. Measures of ability- adequate strength,
flexibility and endurance is needed.
2. Complexity of task- difficulty level of the
subject or the task mastered
3. environmental effects-
4. health status- healthy or ill
5. gender-
M.Q.Espiritu,RN,MAN
Types of Readiness to learn
B. Emotional Readiness;
a. anxiety level
b. support system- family and friends and
significant others
c. motivation- telling cues, start asking
questions and showing interest.
d. risk-taking behavior-develop awareness;
develop strategies to minimize risk
e. frame of minds- priorities of the learner
f. Development stage- teachable moment

M.Q.Espiritu,RN,MAN
Types of Readiness to learn
C. Experiential readiness- previous learning
experiences.
a. level of aspiration- influence motivation
to achieve
b. past coping mechanism- able to cope
with or handle previous problems or
situation
c. cultural background

M.Q.Espiritu,RN,MAN
 d. locus of control- refers to motivation to
learn which may be;
1. internal locus of control or intrinsic-
driven by the desire to know or learn.
2. external locus of control or extrinsic-
motivation to learn is influenced by others
who encourage the learner to learn

M.Q.Espiritu,RN,MAN
e. orientation- refers to person’s point of
view
1. parochial closed-minded thinking,
conservative in their approach to new
situations, less willing to learn to
things/materials.
2. cosmopolitan- worldly perspective and
more receptive to new or innovative
ideas

M.Q.Espiritu,RN,MAN
Types of Readiness to learn
D. Knowledge Readiness-
a. present knowledge base - stock
knowledge; knows about the subject
matter from previous actual or vicarious
learning.
b. cognitive ability- lower level of learning;
memorizing, recalling or recognizing
concepts and ideas.

M.Q.Espiritu,RN,MAN
 Thank You!

M.Q.Espiritu,RN,MAN