Learning

Theories
Facilitated by:
Roberto C. Sombillo RN, PhD
Learning Theory
• A coherent framework and set of integrated constructs and
principles that describe, explain, or predict how people
learn
 • The development and testing of learning
theories over the past century have
Contribution contributed much to our understanding of
of Learning how individuals acquire knowledge and
change their ways of thinking, feeling, and
Theories behaving.
 Focusing mainly on what is directly
observable

Behavioris Behaviorists view learning as the

t Learning product of the stimulus conditions
(S) and the responses (R) that follow
Theory
Sometimes termed the S-R model of
learning.
• To modify people’s
attitudes and responses,
behaviorists
recommend either
altering the stimulus
Modification of
conditions in the Behavior
environment or
changing what happens
after a response occurs
 • Much of behaviorist
Basis of learning is based on
Behaviorist respondent conditioning
and operant conditioning
Learning procedures
 Respondent conditioning or Pavlovian conditioning

Emphasizes the importance of stimulus conditions and

the associations formed in the learning process
Classical
Conditioning A neutral stimulus (NS), a stimulus that has no particular
value or meaning to the learner is paired with a naturally
occurring unconditioned or unlearned stimulus (UCS) and
unconditioned response (UCR).

After a few such pairings, the neutral stimulus alone,

without the unconditioned stimulus, elicits the same
response.
 • Think of a scenario that
you can apply the
Application model of
unconditioned stimulus
producing a
conditioned response
in patient care
 Operant Conditioning

A reinforcer is a stimulus or
B. F. Skinner (1974, 1989), When specific responses
event applied after a
focuses on the behavior of are reinforced on the
response that strengthens
the organism and the proper schedule, behaviors
the probability that the
reinforcement that occurs can be either increased or
response will be performed
after the response decreased.
again.

Two methods to increase

the probability of a
response are to apply
positive or negative
reinforcement after a
response occurs.
Reinforcement

Positive reinforcement (i.e., reward) greatly enhances the

likelihood that a response will be repeated in similar
circumstances.

A patient moans and groans as he attempts to get up and walk

for the first time after an operation, praise and encouragement
(reward) for his efforts at walking (response) will improve the
chances that he will continue struggling toward independence
 Negative reinforcement is a form of
reinforcement involves the removal of an
unpleasant stimulus.

Forms of Escape conditioning, as an unpleasant stimulus

Negative is being applied, the individual responds in
some way that causes the uncomfortable
Reinforcement stimulation to cease. Example: Use of Humor
during an unpleasant situation

Avoidance conditioning has been used to

explain some people’s tendency to become ill
so as to avoid doing something they do not
want to do.
Features of Operant Conditioning

According to operant Skinner (1974) maintained

conditioning principles, that the simplest way to
behaviors may be extinguish a response is
decreased through either not to provide any kind of
nonreinforcement or reinforcement for some
punishment action.
Features of Operant Conditioning

One of the cardinal rules of operant conditioning is to “punish the behavior,

not the person.” If punishment is employed, it should be administered
immediately after the response with no distractions or means of escape.

The purpose of punishment is not to do harm or to serve as a release for

anger; rather, the goal is to decrease a specific behavior and to instill self-
discipline.
 For operant conditioning to be effective, it is
necessary to assess what kinds of
reinforcement are likely to increase or
decrease behaviors for each individual.

Example Not every client, for example, finds health

practitioner’s terms of endearment
Application rewarding.

Comments such as “Very nice job, dear,” may

be presumptuous or offensive to some clients
Example Application

The families of chronic back pain patients have been taught to minimize their attention to the
patients whenever they complain and behave in dependent, helpless ways, but to pay a lot of
attention when the patients attempt to function independently, express a positive attitude,
and try to live as normal a life as possible.

Some patients respond so well to operant conditioning that they report experiencing less pain
as they become more active and involved
Criticisms
Under this model, learners are assumed to be relatively passive and easily manipulated, which raises the
crucial issue of ethics: “Who” is to decide “what” the “desirable” behavior should be?

Too often the desired response is conformity and cooperation to make someone’s job easier or more
profitable.

In addition, the theory’s emphasis on extrinsic rewards and external incentives reinforces and promotes
materialism rather than self-initiative, a love of learning, and intrinsic satisfaction.

Another shortcoming of behavior modification program is that clients’ changed behavior may deteriorate
over time, especially once they are back in their former environment—an environment with a system of
rewards and punishments that may have fostered their problems in the first place.
Cognitive Learning Theory
Cognitive learning theorists stress the importance of what goes on “inside” the
learner

The key to learning and changing is the individual’s cognition (perception,

thought, memory, and ways of processing and structuring information)

A highly active process largely directed by the individual, learning involves

perceiving the information, interpreting it based on what is already known, and
then reorganizing the information into new insights or understanding
Features

Cognitive theorists, unlike

behaviorists, maintain that reward
is not necessary for learning. More To promote transfer of learning,
important are learners’ goals and the learner must mediate or “act
expectations, which create on” the information in some way.
disequilibrium, imbalance, and
tension that motivate them to act.
Perspectives and Application to Patient
Education

Gestalt: focusing on discrete stimuli, gestalt refers to the configuration or

patterned organization of cognitive elements, reflecting the maxim that “the
whole is greater than the sum of the parts.”

Patients in severe pain or worried about their hospital bills may not attend to
well-intentioned patient education information. Second, what individuals pay
attention to and what they ignore are influenced by a host of factors: past
experiences, needs, personal motives and attitudes, reference groups, and the
particular structure of the stimulus or situation
 • Information Processing:
emphasizes thinking
processes and thought,
reasoning, the way
Perspectives information is
encountered and stored,
and memory functioning
Application
The first stage in the memory process involves paying attention to environmental stimuli; attention,
then, is the key to learning. Thus, if a client is not attending to what a nurse educator is saying, perhaps
because the client is weary or distracted, it would be prudent to try the explanation at another time
when he is more receptive and attentive.

In the second stage, the information is processed by the senses. Here it becomes important to consider
the client’s preferred mode of sensory processing (visual, auditory, or motor manipulation) and to
ascertain whether there are sensory deficits.

In the third stage, the information is transformed and incorporated (encoded) briefly into short-term
memory, after which it is either disregarded and forgotten or stored in long term memory. Long-term
memory involves the organization of information by using a preferred strategy for storage (e.g., imagery,
association, rehearsal, breaking the information into units).
While long-term memories are enduring, a central problem is retrieving the stored information at a
later time.

The last stage involves the action or response that the individual makes on the basis of how
information was processed and stored. Education involves assessing how a learner attends to,
processes, and stores the information that is presented as well as finding ways to encourage the
retention and retrieval processes.

Errors are corrected by helping learners “reprocess” what needs to be learned. Neuropsychologists
have contributed to understanding the physiological mechanisms underlying memory and
information processing
 • Jean Piaget is the best-known cognitive
developmental theorist, and his observations
of children’s perception and thought
Jean Piaget processes at different ages have contributed
Cognitive much to our recognition of the unique ways
that youngster’s reason, the changes in their
Theory ability to conceptualize, and their limitations
in understanding, communicating, and
performing
Piaget identified and described four Children take in information as they
sequential stages of cognitive interact with people and the
development (sensorimotor, environment and either make their
preoperational, concrete operations, experiences fit with what they
and formal operations) that become already know (assimilation) or
evident over the course of infancy, change their perceptions and
early childhood, middle childhood, interpretations in keeping with the
and adolescence. new information (accommodation).
Video Appreciation and Application
 learning occurs by observation—
watching other people and
Social discerning what happens to them.

Learning
Learning is often a social process,
Theory and other individuals, especially
“significant others,” provide
compelling examples or role models
for how to think, feel, and act.
 Role Modeling

Role modeling is a central concept of the theory.

As an example, a more experienced nurse who demonstrates

desirable professional attitudes and behaviors sometimes is used
as a mentor for a less experienced nurse, while medical students,
interns, and residents are mentored by attending physicians
Vicarious reinforcement is another concept from the social learning
theory and involves viewing other people’s emotions and
determining whether role models are rewarded or punished for
their behavior

The behavior of a role model may be imitated, even when no

reward is involved for either the role model or the learner
• Bandura (1977) outlined a four-step, largely internal process that directs
social learning.
• First phase is the attentional phase, a necessary condition for any
learning to occur
• Role models with high status and competence are more likely to be
observed, although the learner’s own characteristics (needs, self-esteem,
competence) may be the more significant determiner of attention
Second is the retention phase, which involves the storage and retrieval of
what was observed.

Third is the reproduction phase, where the learner copies the observed
behavior. Mental rehearsal, immediate enactment, and corrective
feedback strengthen the reproduction of behavior

Fourth is the motivational phase, which focuses on whether the learner is

motivated to perform a certain type of behavior.
• Bandura (2001) has shifted his focus to
sociocultural influences, viewing the learner
as the agent through which learning
experiences are filtered. As he argues, the
human mind is not just reactive; it is
“generative, creative, and reflective.”
Psychodynamic Theories

Psychodynamic perspective A central principle of the theory

emphasizes the importance of is that behavior may be
conscious and unconscious conscious or unconscious—that
forces in guiding behavior, is, individuals may or may not
personality conflicts, and the be aware of their motivations
enduring effects of childhood and why they feel, think, and
experiences. act as they do.
Psychodynamic Theory
Defense
Mechanism
Eric Erickson’s Psychosocial Theory
Features

The importance of emotions

Underlying the humanistic
and feelings, the right of
perspective on learning is the
individuals to make their own
assumption that each individual
choices, and human creativity
is unique and that all individuals
are the cornerstones of a
have a desire to grow in a
humanistic approach to
positive way.
learning
Reminder • The psychodynamic approach reminds
health professionals to pay attention to
emotions, unconscious motivations, and the
psychological growth and development of all
those involved in health care and learning.
 • This theory is well suited to understanding
patient and family noncompliance
(Menahern & Halasz, 2000), trauma and loss
(Duberstein & Masling, 2000), palliative care
Application and the deeply emotional issues of terminal
illness (Chochinov & Breitbart, 2000), and
the stresses of working with long term care
residents (Goodwin & Gore, 2000).
Criticisms

Analysis is speculative and subjective.

Health professionals’ biases, emotional conflicts, and needs may distort their evaluation of other
persons and situations.

It is not the job of health professionals with little clinical psychology or psychiatric training to probe
into the private lives and feelings of patients so as to uncover deep, unconscious conflicts

Psychodynamic principles as a way of explaining away, rather than dealing with, people as
individuals who need emotional care.
 Maslow Hierarchy of Needs
a humanistic perspective, motivation is derived from each person’s needs, subjective
feelings about the self, and the desire to grow

The transfer of learning is facilitated by curiosity, a positive self-concept, and open

situations where people respect individuality and promote freedom of choice. Under
such conditions, transfer is likely to be widespread, enhancing flexibility and creativity

At the bottom of the hierarchy are physiological needs (food, warmth, sleep); then
come safety needs; then the need for belonging and love; followed by self-esteem. At
the top of the hierarchy are self-actualization needs (maximizing one’s potential).
 Assumptions
Additional considerations include cognitive needs (to know and understand)
and, for some individuals, aesthetic needs (the desire for beauty).

An assumption is that basic-level needs must be met before individuals can be

concerned with learning and self-actualizing.

Thus, clients who are hungry, tired, and in pain will be motivated to get these
biological needs met before being interested in learning about their
medications, rules for self-care, and health education.
• Although some people’s basic needs may not be met, they may
nonetheless engage in creative activities, extend themselves to other
people, and enjoy learning (Pfeffer, 1985).
• Besides personal needs, humanists contend that self-concept and self-
esteem are necessary considerations in any learning situation.
Application of Maslow Hierarchy of Needs
Take Away Video
 “a strong case can be made that ... variables
Model of of culture, ethnicity, personality and
political ethos assume far greater
Adult significance in explaining how learning
Learning occurs and is experienced than does the
variable of chronological age.”
 • Malcolm Knowles (1984)
•Father of Adult Learning
Model of • “Facts learned in youth have
become insufficient and, in
Adult many instances, actually
untrue; and skills learned in
Learning youth have become
outmoded by new
technologies.”
Model of Adult Learning • He began to crusade for
a model of education
for adults that was
different from the
education of children.

• He adopted the term

andragogy (teaching
adults) to differentiate
the teachings of adults
from pedagogy (leading
children) , the teaching
of children.

Pedagogy (leading children) Andragogy (teaching adults)

 Adult vs. Child Learners

ADULT CHILD
 Problem-centered  Subject-oriented
 Results-oriented  Future-oriented
Self-directed Depend on adults
Model of
 

 Skeptical about  Accept new info

Adult 
new information
Seek education 
without question
Seek education
Learning that applies to
their current lives
that prepares
them for future
 Accept  Depend on others
responsibility for to design much
own learning of their learning
Model of Adult
Learning
• Andragogy makes assumption
about the design of learning;
• Adults need to know why to learn
• Adults need to learn
experientially
• Adults’ approach learning as
problem solving
• Adults learn best when the topic
is of immediate value
Types of • Robert M. Gagne (1916-
Learning 2002)
• He theorized that there are
eight types of learning,
beginning with the very
"Learning is simple S-R units which can
something that be built-up hierarchically.
takes place inside
a person's head- in
the brain"
 Types of Learning

Signal Learning or Stimulus-Response

Chaining
Conditioned Response Learning
• On this simplest level • It involves developing • It is the acquisition of
of learning, the a voluntary response a series of related
person develops a to a specific stimulus conditioned
generally diffuse or combination of responses or
reaction to a stimuli. stimulus-response
stimulus. connection.
 Verbal Association

• It is a sub-variety of chaining. The meaning of the

word is discovered by recognizing its connection with
another word.

Types of
Discrimination Learning

• The more chains that are learned, the easier it is to

Learning forget previous chain. To learn and retain large

number of chains, the person has to be able to
discriminate among them.

Concept Learning

• It is learning how to classify stimuli into groups

represented by a common concept.
 01 02
Types of Rule Learning Problem Solving
Learning • It can be considered a
chain of concepts or a
• It is combining
principles into higher
relationship between order principles. It is
concepts. chain of two or more
concepts.
Learning Style Models
• 1. Holistic model
• Holistic thinkers want to get the whole picture quickly
or get the gist of things. They want to see broad
categories before they look at details.

• 2. Analytical model
• They process the details of a picture, outlining the
component parts in a logical progression. They
perceive information in an objective manner and do
not need to connect it to their personal values or
experiences.
Learning Style Models

• A verbal learner
3. Verbal experience information in
model terms of words or verbal
association.

• They experience
4. Visual information they read, see,
representation or hear in terms of mental
model pictures or images.
Theory of Experiential
Learning
David A. Kolb
He depicts learning as a Four-stage cycle and later
hypothesized that learners need four abilities in
order to be effective.
Theory of Experiential Learning

People

Concrete Experience
( CE )
Feel Hear
See Touch Taste

Learning from Actual Experience

Creating Theories to explain what is

seen
Experts Theory
Abstract
Conceptualization
( AC)
Books
Theory of Experiential Learning

Reflective
Observers
( RO )
Learning by observing others

Active
Experimenters
( AE )
Using theories to solve problems
Theory of Experiential Learning

Active Experimentation

Converger Accomodator

Abstract Concrete
Conceptualization Experience

Assimilator Diverger

Reflective Observation
Kolb’s Learning Style Inventory
Part I: Concrete
Experience vs. Abstract
Conceptualization

• A. hands-on learning experiences.

I prefer • B. learning through thinking and reasoning.

• A. rely on feelings when making decision.

I tend to • B. rely on logical reasoning when making
• decisions.
Kolb’s Learning Style Inventory

3. I learn more • A. my peers

effectively from • B. my teachers

4. I like learning • A. simulations

through • B. lectures

5. I learn well • A. practical experience

by • B. applying theories
 Part II: Active Experimentation vs. Reflective Observation

Kolb’s 1. I learn best through

Learning • C. active involvement in projects

• D. observation
Style 2. I would rather

Inventory • C. do volunteer work with disadvantage youth

• D. read about disadvantage youth

3. I prefer assignments that

• C. require me to work
• D. require me to think about situation
 4. I learn well through

• C. participating in a discussion
Kolb’s • D. listening to what others have to
Learning say
Style
Inventory 5. I tend to

• C. jump right in and do something

new.
• D. think about possible outcomes
before trying something new.
 Part I: Total of A’s _____ CE score
Total of B’s _____ AC score
Part II: Total of C’s _____ AE score
Total of D’s _____ RO score
Kolb’s A responses= Concrete Experience
Learning Style B responses= Abstract conceptualization
Inventory C responses= Active Experimentation
Interpretation D responses= Reflective Observation
AC/AE – Converger
AC/RO – Assimilator
CE/AE – Accomodator
CE/RO - Diverger
Theory of Experiential Learning

Accommodator The Accommodating learning These people use other people's

(doing and feeling ) style is 'hands-on’ and relies on analysis, and prefer to take a
(CE/AE) intuition rather than logic. practical, experiential approach.

People with an Accommodating

They are attracted to new They commonly act on 'gut'
learning style will tend to rely on
challenges and experiences, and instinct rather than logical
others for information than carry
to carrying out plans. analysis.
out their own analysis.

People with an Accommodating

learning style prefer to work in
This learning style is prevalent
teams to complete tasks. They
and useful in roles requiring
set targets and actively work in
action and initiative.
the field trying different ways to
achieve an objective.
Theory of Experiential Learning

Diverger These people are able to

(feeling and watching) look at things from different They are sensitive.
(CE/RO) perspectives.

Kolb called this style

They prefer to watch rather
'Diverging' because these
than do, tending to gather They are best at viewing
people perform better in
information and use concrete situations several
situations that require
imagination to solve different viewpoints.
ideas-generation, for
problems.
example, brainstorming.

They are interested in People with the Diverging

People with a Diverging
people, tend to be style prefer to work in
learning style have broad
imaginative and emotional, groups, to listen with an
cultural interests and like to
and tend to be strong in the open mind and to receive
gather information.
arts. personal feedback.
 Theory of Experiential Learning
Assimilator The Assimilating learning These people require good
Ideas and concepts are more
(watching and thinking) preference is for a concise, clear explanation rather
important than people.
(AC/RO) logical approach. than practical opportunity.

People with an Assimilating People with this style are

They excel at understanding These learning style people
learning style are less more attracted to logically
wide-ranging information is important for
focused on people and more sound theories than
and organising it a clear effectiveness in information
interested in ideas and approaches based on
logical format. and science careers.
abstract concepts. practical value.

In formal learning situations,

people with this style prefer
readings, lectures, exploring
analytical models, and
having time to think things
through.
Theory of Experiential Learning
People with a Converging
Converger They prefer technical tasks
learning style can solve
and are less concerned
(doing and thinking ) problems and will use their
with people and
(AC/AE) learning to find solutions
interpersonal aspects.
to practical issues.

People with a Converging

People with a Converging They can solve problems
learning style are more
learning style are best at and make decisions by
attracted to technical tasks
finding practical uses for finding solutions to
and problems than social
ideas and theories. questions and problems.
or interpersonal issues.

People with a Converging

A Converging learning style style like to experiment
enables specialist and with new ideas, to
technology abilities. simulate, and to work with
practical applications.
Thank you!

“Learning is a treasure that will follow its owner everywhere.”

Chinese Proverb