Module 8
Domains of Learning
David E. Gesner, MA, NREMT-P
Level A FL EMS Instructor
Course Curriculum
Cognitive Goals
Use his or her own words to state a
definition of cognitive, psychomotor and
affective domains of learning.
Identify the domain of learning and level of
depth for a correctly written objective.
Give examples of behaviors that exemplify
the three domains of learning.
Level A FL EMS Instructor
Course Curriculum
Cognitive Goals
Within the context of an EMS call, identify
knowledge and behavioral examples for
cognitive, psychomotor and affective
domains.
List classroom activities for each domain of
learning.
State at least one appropriate evaluation
method for each domain of learning.
Level A FL EMS Instructor
Course Curriculum
Psychomotor Goals
There are no psychomotor objectives for this
module.
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Course Curriculum
Affective Goals
Acknowledge the need to teach within the
three domains of learning as identified within
the National Standard Curriculum for any
level of EMS course.
Support activities that teach and evaluate
the three domains of learning.
Value all three domains of performance by
the EMS professional.
Level A FL EMS Instructor
Course Curriculum
Why This Module is Important
“Pedagogy” is defined as the art and science of
teaching.
– Teaching is both art and science.
– The art of teaching involves creative aspects like
instructional design, developing classroom presentation
skills, etc.
– The science of teaching is based in educational
psychology and research and deals with learning
theories and preferences, how people think, the
domains of learning, and other aspects of learning.
Level A FL EMS Instructor
Course Curriculum
Why This Module is Important
The Domains of learning are a tool for
understanding how people think, feel and
act.
By understanding the domains of learning
we can better plan what needs to be taught
and how far we need to go through the
material.
– Also called "depth and breadth"
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Course Curriculum
Domains of Learning
Developed by Benjamin Bloom, et al, in 1956
– His research described the major areas of learning and
thinking and classified them into three large groups
called the domains of learning:
Cognitive (thinking).
Affective (feeling).
Psychomotor (doing).
– The degree of sophistication increases as you extend
deeper into the list requiring greater depth and breadth
for mastery of that level.
Level A FL EMS Instructor
Course Curriculum
Bloom's Taxonomy of the Domains of
Learning by Degrees of Sophistication
Cognitive Psychomotor Affective
Domain Domain Domain
Knowledge Imitation Receiving
Comprehension Manipulation Responding
Application Precision Valuing
Analysis Articulation Organization
Synthesis Naturalization Characterization
Evaluation
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Course Curriculum
Domains of Learning
The domains of learning are used in
instructional design to write goals and
objectives for a curriculum.
– Commonly used in EMS educational products.
– Serve as a means for instructors to decide
about depth and breadth issues when
developing lesson plans.
– Serve as a means for instructors to develop test
questions.
Level A FL EMS Instructor
Course Curriculum
Levels Within the Domains of
Learning
Level Cognitive Psychomotor Affective
Domain Domain Domain
Level 1: Knowledge Knowledge Imitation Receiving
(low level) Comprehension Manipulation Responding
Level 2: Application Application Precision Valuing
(intermediate level)
Level 3: Problem Analysis Articulation Articulation
solving (high level) Synthesis Naturalization Naturalization
Evaluation
Level A FL EMS Instructor
Course Curriculum
Levels Within the Domains of
Learning
As the student progresses from one level to
the next within a given domain of learning a
deeper and fuller understanding of the
material is required.
Two strategies to classify these levels.
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Lower and Higher Levels
This strategy places the levels into two categories.
The first level (or first two levels) of each domain is
considered the lowest level.
– Levels beyond this level are considered higher levels.
Sometimes this strategy is confusing as there are
no clear division points between high level and low
level resulting in greater of subjectivity.
Level A FL EMS Instructor
Course Curriculum
Three Level System
Groups the levels of each domain into one
of three categories:
– Knowledge
– Application
– Problem-solving
Level A FL EMS Instructor
Course Curriculum
Knowledge: First (lowest) Level
Helps students comprehend facts,
procedures and feelings.
Includes simple skills or thought processes
like imitation, recall, definitions of terms,
receiving and responding to new
information.
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Application: Second (some low some
high) Level
Builds upon the foundation established in
the knowledge level.
Involves the integration and execution of
principles, procedures and values within
specific situations.
Includes precision in the skills execution, the
application of principles and valuing feelings
and beliefs.
Level A FL EMS Instructor
Course Curriculum
Problem Solving: Third (highest)
Level
i. Builds upon the application level and
indicates that mastery has been achieved.
Involves the analysis of information,
procedures, and feelings in order to modify
and adapt specific tasks depending upon
situations.
When an individual is at the farthest part of
this level they are capable of metacognition
(thinking about thinking).
Level A FL EMS Instructor
Course Curriculum
Three Level System
As stated previously, the language of the
objective should clue you in to the level of
depth and breadth you should cover for the
material.
The appendix has information on verbs
commonly used to describe objectives for
each domain of learning.
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Course Curriculum
Common Cognitive Verbs
Define
Know
Describe
Design
Analyze
Discuss,
Identify
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Common Psychomotor Verbs
Demonstrate
Show
Perform
Conduct
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Common Affective Verbs
Defend
Appreciate
Value
Model
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You Cannot Push Students Through
the Levels
They must be allowed to move from level to
level on their own or with your guidance
If you push them from one level to the next
too quickly they will not learn the material
and will make mistakes
Level A FL EMS Instructor
Course Curriculum
The Cognitive Domain
Deals with didactic information; knowledge
and facts.
Consists of six (6) levels of sophistication
from simplest to most complex.
Level A FL EMS Instructor
Course Curriculum
The Cognitive Domain:
Six Levels of Sophistication
Knowledge (Level 1) memorization and
recall.
Comprehension (Level 1) interpretation
and understanding of the meaning behind
the information.
Application (Level 2) application of
classroom information to real-life situations
and experiences.
Level A FL EMS Instructor
Course Curriculum
The Cognitive Domain:
Six Levels of Sophistication
Analysis (Level 3) separation of the whole
into parts in order to analyze their meaning
and understand their importance.
Synthesis (Level 3) combining of pieces of
information into a new or different whole.
Evaluation (Level 3) making judgments and
decisions about and with the information
presented.
Level A FL EMS Instructor
Course Curriculum
The Psychomotor Domain
Deals with skills, actions and manual
manipulation.
Consists of five (5) levels from basic to
complex.
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Course Curriculum
The Psychomotor Domain:
Five Levels of Sophistication
Imitation (Level 1) repeated the example
given by instructor or role model.
Manipulation (Level 1) practicing and
creating his or her own style.
Precision (Level 2) performs skill without
mistakes.
Level A FL EMS Instructor
Course Curriculum
The Psychomotor Domain:
Five Levels of Sophistication
Articulation (Level 3) proficient and
competent performance of skill with style or
flair.
Naturalization (level 3) mastery level skill
performance without cognition.
– Sometimes referred to as “muscle memory” or
automatic.
Level A FL EMS Instructor
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The Affective Domain
Deals with attitudes, beliefs, behaviors,
emotions and how much value an individual
places on something.
Considered the most difficult domain to
evaluate.
Consists of five levels from simple to
complex.
Level A FL EMS Instructor
Course Curriculum
The Affective Domain:
Five Levels of Sophistication
Receiving (Level 1) awareness of the value
or importance of learning the information
and a willingness to learn.
Responding (Level 1) willingness to
actively participate in the learning process
and deriving satisfaction from doing so.
Level A FL EMS Instructor
Course Curriculum
The Affective Domain:
Five Levels of Sophistication
Valuing (Level 2) perception that behavior
has worth.
Organization (Level 3) integration of
different beliefs, reconciling differences.
Characterization (Level 3) development of
one’s own value system that governs one’s
behavior.
Level A FL EMS Instructor
Course Curriculum
Classroom Activities to Target Each
Domain
Cognitive - lecture, discussion, reading,
diagramming, case studies and drills.
Level A FL EMS Instructor
Course Curriculum
Classroom Activities to Target Each
Domain
Psychomotor - skills practice, scenarios,
simulations, and role playing.
Level A FL EMS Instructor
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Classroom Activities to Target Each
Domain
Affective - modeling behaviors you expect
the students to emulate (tolerance,
punctuality, respect, kindness, honesty and
integrity), role playing situations involving
affective domain content, sensitivity training
and awareness courses.
Level A FL EMS Instructor
Course Curriculum
Evaluation of the Domains of
Learning
Learning within one domain of learning is
often interdependent with another domain.
– Psychomotor skills development requires
cognitive knowledge of the parts, concepts and
processes for practice to be most effective.
For example: A student will achieve mastery of
endotracheal intubation faster if he can identify the
needed equipment, understand the indications for the
skill, and recite the sequence of events for
completion of the skill before he ever attempts the
skill.
Level A FL EMS Instructor
Course Curriculum
Evaluation of the Domains of
Learning
Some educational learning models
encourage an environment where students
do a high amount of experimenting as a
means to learn, but even in these situations
the student should be guided and mentored
by the instructor.
– These learning situations are most successful
with students who possess a high level of self-
directedness (ability to easily motive themselves
who have a passion for learning).
Level A FL EMS Instructor
Course Curriculum
Evaluation of the Domains of
Learning
Review the course and lesson objectives to
determine depth and breadth.
– 1. Try to teach one level deeper than the
objective requires because over time, memory
degradation will result in the loss of retention of
some of the information.
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Course Curriculum
Evaluation of the Domains of
Learning
Research shows that the more senses that
are engaged in the learning process the
more material is retained for a longer period
of time.
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Evaluation of the Domains of
Learning
We remember about 10% of what we read.
About 20% of what we hear.
About 30% of what we see.
About 40% of what we see and hear.
About 70% of what we can describe and talk
about (say).
About 90% of what we can say and do.
Level A FL EMS Instructor
Course Curriculum
Evaluation of the Domains of
Learning
Research also shows that the more times
material is reviewed and reinforced the more
it is retained in long term memory.
Level A FL EMS Instructor
Course Curriculum
Depth and Breadth Samples
Example 1: Objective A states the student
should take a supplied list of names of 10
organs and label those organs on a
mannequin and Objective B states the
student should draw a human skeleton and
label all of the major bones from memory.
– Objective A deals with a much lower level of
cognition (knowledge) than objective B
(synthesis) so you should be very thorough on
teaching objective B compared to objective A.
Level A FL EMS Instructor
Course Curriculum
Depth and Breadth Samples
Example 2: Objective C states the student
should be able to take an empty oxygen
cylinder and switch the regulator to a full
tank.
– If all you have ever discussed or demonstrated
is how to open the tank and check it for leaks it
is unlikely that your students will be successful
in an evaluation of this skill.
Level A FL EMS Instructor
Course Curriculum
Depth and Breadth Samples
Example 3: Objective D states the student
should be able to list the “5 patient
medication rights” and you only stressed 3
or 4 of them.
– It is unlikely that the students will be able to
successfully test on this objective unless they
are highly self-motivated and learned it on their
own through reading, a study group or a tutoring
session.
Level A FL EMS Instructor
Course Curriculum
Knowledge Does Not Imply
Competency
Cognitive knowledge of a skill does not
imply competency in performance of the
skills.
– Cognitive knowledge must be integrated with
psychomotor skill practice and performance.
– Example: A student who can answer multiple-
choice exam questions about the procedure for
spinal immobilization is not necessarily able to
fully immobilize a patient without compromising
the spine.
Level A FL EMS Instructor
Course Curriculum
Evaluating the Affective Domain
The appendix has a tool that will be useful in
evaluating the affective domain.
This tool comes from the
DOT/NHTSA/HRSA EMT-P curricula.
– See APPENDIX V.
Level A FL EMS Instructor
Course Curriculum
Evaluation Methods for Each
Domain
Cognitive - written examinations, static
presentations, and oral examinations.
Psychomotor - skill competency exam,
scenario-based exam, evaluation in clinical
or field setting, on-the-job performance.
Affective - class participation, leadership,
peer supervision, role modeling, adherence
to policies.
Level A FL EMS Instructor
Course Curriculum
Evaluation Methods for Each
Domain
Most students have a preference or aptitude
for one learning domain over another.
Some students are excellent in the
classroom, but struggle with the
psychomotor skills of EMS, and vice versa.
Level A FL EMS Instructor
Course Curriculum
Evaluation Methods for Each
Domain
The EMS profession requires use of all
three domains.
Minimum competency in all domains must
be achieved for practice as a professional in
EMS.
Level A FL EMS Instructor
Course Curriculum
Evaluation Methods for Each
Domain
For example, an EMT must KNOW
(cognitive) the indications for oxygen
therapy, RECOGNIZE (cognitive) the signs
and symptoms of respiratory distress, be
able to ASSEMBLE (psychomotor) an
oxygen tank and flow the oxygen, and
APPRECIATE (affective) the level of
distress and anxiety felt by the patient in
order to effectively treat the patient.
Level A FL EMS Instructor
Course Curriculum
Bibliographical Resources
Anderson, C. W., & Krathwohl, D. R. Eds.
(2001). A taxonomy for learning, teaching
and assessing a review of Bloom's
taxonomy of educational objectives. Boston:
Addison Wesley Longman, Inc.
Bloom, Benjamin S. et al. (1956). Taxonomy
of Educational Objectives, Book I: Cognitive
Domain. New York: Longman.
Level A FL EMS Instructor
Course Curriculum
Bibliographical Resources
Coles, C. R. (1990). Evaluating the Effects
Curricula Have on student Learning: Toward
a more competent theory for medical
education.
Gagne, R. M., Briggs, L.J. (1979). Principles
of Instructional Design. New York: Holt,
Rinehart and Wilson.
Level A FL EMS Instructor
Course Curriculum
Bibliographical Resources
Hodell, Chuck. (1997) Basics of Instructional
Systems Development. ASTD Info-line,
Issue 9706.
McClincy, William D. (1995). Instructional
Methods in Emergency Services. New
Jersey: Brady Publishers.
Level A FL EMS Instructor
Course Curriculum
Bibliographical Resources
Whittle, J. (2001). 911 Responding for Life.
New York: Delmar Publishers.
Williams, L. (1983). Teaching for the Two-
Sided Mind. Simon & Schuster.
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