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• Learning is a relatively permanent change in mental processing, emotional functioning, and behavior as a result of experience
• Learning Theory provides a framework of constructs and principles that describe, explain, or predict how people learn

Contribution of Learning Theories

• Learning theories give information to guide teaching
• Learning theories can be employed individually or in combination
• Learning theories apply in settings for personal growth and interpersonal relations
• Learning theories apply at the individual, group, and community levels
• Learning theories help teach new material, solve problems, change unhealthy habits, build relationships, manage emotions, and develop effective behavior
• Behaviorist, cognitive, and social learning theories often apply to patient education and healthcare practice

Emotions and Feelings in Learning

• Emotions and feelings need explicit focus regarding learning in general and healthcare in particular
• Emotional reactions are often learned by experience
• Emotional reactions play a role in learning and are vital when dealing with health, wellness, medical treatment, recovery, healing, and relapse prevention
• Psychodynamic and humanistic perspectives add much to the understanding of human motivation, emotions, and the learning process

Comparing Learning Theories

• Theories are compared with regard to:
• Procedures for changing behavior
• Assumptions about the learner
• The role of the educator
• Sources of motivation
• Ways in which learning is transferred to new situations and problems

Behaviorist Theory

• These are key concepts: stimulus conditions, reinforcement, response, and drive
• Behaviorist theory alters the stimulus conditions in the environment and the reinforcement after a response to change behavior

Behaviorist Dynamics

• Motivation: drives to be reduced, incentives
• Educator: active role through the manipulation of environmental stimuli and reinforcements to direct change
• Transfer: practice and provide similarity in stimulus conditions and responses with a new situation

Behaviorist Theory Focus

• Focus is on the directly observable, learning comes from stimulus conditions (S) and responses (R)
• Behaviorists recommend altering the stimulus conditions in the environment or changing actions after a response to modify people's attitudes and responses

Respondent 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 which elicits the conditioned response
• Is also termed classical or Pavlovian conditioning
• Emphasizes the importance of stimulus conditions and the associations formed in the learning process
• A neutral stimulus (NS) lacks particular value or meaning, it's paired with an unconditioned or unlearned stimulus (UCS) and unconditioned response (UCR)
• After pairings, the neutral stimulus alone elicits the same response, learning takes place as the conditioned stimulus (CS) associates with the conditioned response (CR)
• Emphasizes "atmosphere" and staff morale in healthcare
• Patients and visitors make associations as a result of their hospital experiences, providing the basis for long-lasting attitudes toward medicine, healthcare facilities, and health professionals

Systematic Desensitization

• Its use, in psychology, is to reduce fear and anxiety
• Is based on respondent conditioning
• Fear of a stimulus/situation has been learned and can be "unlearned"
• Individuals are taught relaxation techniques
• The stimulus comes at a non-threatening level preventing anxiety and emotions
• Continued pairings results in the individual learning that no real harm will present from the stimulus
• The patient is able to confront the stimulus without fear

Stimulus Generalization

• Initial learning experiences are applied to other similar stimuli
• A positive or negative personal encounter may color patients' evaluations of their hospital stays
• It may also affect subsequent feelings about being hospitalized again
• Individuals learn to differentiate among similar stimuli as well as discrimination learning occurs with more experiences

Spontaneous Recovery

• A response may appear extinguished, may possibly "recover" and reappear at any time
• This especially occurs when stimulus conditions are similar to those in the initial learning experience

Operant Conditioning

• Focuses on the behavior of the organism and the reinforcement that follows response (B. F. Skinner 1974, 1989)
• A reinforcer is a stimulus/event applied after a response
• Reinforcements strengthen the probability that the response will be performed
• Behaviors can be increased/decreased depending on reinforcement

Operant Conditioning Learning Process

• It occurs as the organism responds to stimuli in the environment and is reinforced for making a response
• Reinforcements strengthen the probability that the response will be performed again under similar conditions

Changing Behavior through Operant Conditioning

• To increase behavior: positive reinforcement or negative reinforcement (escape or avoidance conditioning)
• To decrease behavior: non-reinforcement or punishment
• Use of reinforcement is central to the success of operant conditioning procedures
• Should be determined, what kinds of reinforcement are likely to affect behaviors for each person

Cognitive Theory

• Consists of cognition, gestalt, perception, developmental stage, information-processing, memory, social constructivism, social cognition, and attributions
• Work with the developmental stage and change cognitions, goals, expectations, equilibrium, and ways of processing information to change behavior

Cognitive Dynamics

• Motivation: goals, expectations, disequilibrium, cultural and group values
• Educator: organize experiences and make them meaningful and encourage insight and reorganization within learner
• Transfer: focus on internal processes and provide common patterns with a new situation

Gestalt Perspective

• Keys to learning are the patterning of stimuli and perception
• Each learner interprets and reorganizes experiences in their own way
• Learning occurs through reorganizing elements for insights and understanding
• Perception is selective
• Individuals orient themselves to certain features of an experience while possibly screening out others due to inability to attend to all surrounding stimuli
• What individuals pay attention to is influenced by past experiences, needs, personal motives and attitudes, reference groups, and the particular format of the stimulus
• It is one of the oldest schools of psychology

Information-Processing Perspective

• The way individuals perceive, process, store, and retrieve information determines how learning occurs

Information-Processing Perspective Assistance in Leaning:

• Organizing information helps the attention and storage process.
• Learning occurs through guidance, feedback, and assessing and correcting errors.

Stages of Information-Processing

• First Stage: Giving full attention to environmental stimuli is key to learning
• Second stage: Information processed by the senses. Consider sensory processing of the client
• Third stage: the information gets transformed (encoded) briefly into short-term memory, which can be disregarded (forgotten), or moved to long-term memory
• Long-term memory: Using a strategy to organize the information for storage. Examples: imagery, association, rehearsal, and breaking down information

Final Information-Processing Stage

• Involves the action or response that is made based on how the information was stored and processed
• Memory processing and the retrieval of information are enhanced by organizing information which makes it meaningful

Steps in Information-Processing

• External processes use stages 1 and 4 involving attention and action
• Internal processes use stages 2 and 3 and involve processing and memory storage

Information-Processing Perspective Aid

• This perspective assessing problems in acquiring, remembering, and recalling information is particularly helpful
• Have learners indicate view of how they are learning process
• Ask learners to describe what thinking that occurs when learning
• Give attention to their inability to demonstrate the learned information

Activating Effective Learning

• 9 Events
• Gain the learner's attention (reception)
• Inform the learner of the objectives and expectations (expectancy)
• Stimulate the learner's recall of prior learning (retrieval)
• Present information (selective perception)
• Provide guidance to facilitate the learner's understanding (semantic encoding)
• Have the learner demonstrate the information or skill (responding)
• Give feedback to the learner (reinforcement)
• Assess the learner's performance (retrieval)
• Work to enhance transfer and retention thru varied practice and application (generalization)

Cognitive Development Perspective

• Focuses on qualitative changes in perceiving, thinking, and reasoning as individuals grow and mature
• Cognitions are based on how external events are conceptualized and organized within each person's schema
• Learning is a developmental, active process with the child interacting with the environment, makes discoveries

Cognitive Development Assimilation and Accommodation

• Children take in information as they interact and either make their experiences line up with what they already know (assimilation) or change their perceptions in keeping with the new information (accommodation)

Social Constructivist Perspective

• Learning is influenced by culture and occurs socially through relationships
• A person's knowledge may not reflect true reality; however new understanding is gained through negotiation and collaboration
• tenets include influence to the learning process and effective learning through collaboration, interaction, and negotiation

Social Cognition Perspective

• Perceptions, beliefs, and social judgments are affected by social interaction, communication, groups, and situations
• Individuals find causal explanations which can dictate behavior with the social environment having a large effect on development

Social Learning Theory

• Concepts: role modeling, vicarious reinforcement, self-system, and self-regulation
• To change behavior, use effective role models viewed to be rewarded and work alongside internal self-regulating mechanisms
• Learning occurs by watching other people and discerning what happens to them
• It has been applied to staff training and to interventions
• Interventions address public health issues like teenage smoking and alcoholism during older age

Social Learning Dynamics

• Motivation: role models viewed to be rewarded, self-system regulating behavior, and self-efficacy
• Educator: models behavior and demonstrates benefits
• Educator Encourages the learner to actively regulate and reproduce desired behavior
• Transfer: similarity of setting, feedback, social influences, self-efficacy

Social Learning Phases

• The attentional phase, is a prerequisite to any type of leaning
• Storage and retrieval of what was viewed occurs during the retention phase
• The learner copies the behavior in the reproduction phase
• The motivation phase focuses on whether the learner is motivated to perform the behavior

Psychodynamic Theory

• Key components are: stage of personality development, unconscious motivations, ego-strength, emotional conflicts, and defense mechanisms
• To change behavior: make unconscious motivations conscious and build ego-strength, to manage any emotional conflicts

Psychodynamic Dynamics

• Motivation: libido, life force, death wish, pleasure principle, reality principle, conscious and unconscious conflicts, developmental stage, defenses
• Educator: reflective interpreter, pose questions to stimulate insights
• Transfer: remove barriers such as resistance, transference reactions, and emotional conflicts.

Id, Ego and Super-Ego

• Personality consists of three parts, the id, ego, and super-ego
• The id is a primitive and instinctive part of personality, and consists of inherited/biological components of personality at birth
• Biological components are related to components like the sex (life) instinct - Eros (libido), and the aggressive (death) instinct/ Thanatos
• The ego develops to mediate between the unrealistic id and the external real world
• The superego incorporates acquired values/morals of society that are taught through parental/societal figures
• Any conflicts made between the conscious and unconscious mind causes anxiety, which can affect the ego and the use of defence mechanisms

Defense Mechanisms

• Common defense mechanisms are: intellectualization, projection, reaction formation, sublimination, and compensation

Humanistic Theory

• Motivation comes comes from our own needs, a desire to grow and a positive self-concept -The educator acts as a facilitator, respects the learners' uniqueness and allows them for creative growth -Freedom promotes positive and negative feelings, promotes positive learning, and can inhibit transfer

Humanist Dynamics

• Motivation in humanistic theory is defined by needs, desire for growth or general self-concept
• In this, the educator acts as a facilitator for learning, and provides the support and respect that learners' need
• Barriers removeal and emotional confidence in the learning enviornment will promote natural transference of motivation

Emotions In Humanistic Theory

-Learning is affected by emotion, feelings, and any other sense or connection

• It is important to focus on connection and humanity in order to get to the full effect of learning or changing behavior.

Generalizations about Learning

• Learning is a factor of developmental changes with processing that is different for each learner
• Is an active, multi-faceted and complex task process Stress can stimulate or interfere with learning

Environmental Influences (External)

• Stimulus conditions and configuration of elements affect understanding
• Additionally: Social/cultural influences, role models, reinforcement and feedback all play roles in learning

Internal Influences

• Developmental stage Habits, perception, thoughts and reasoning/ Schema all factor in the quality of learning
• Internal feelings also will reflect the state of learning

Promoting Change

• Relate info to what learner already knows
• Keep experiences simple, and meaningful. Give the learner proper needed motivation.

Promote Change Through:

• Providing experiences that fit their development
• Making the experience positive, show guidance and provide role models.

How To Promote Permanent Knowledge

• Relate experiences to learner and reinforce good behavior.
• Practice different settings while providing constructive feedback
• Be sure to remove any interferences, at any point.

How To Create Lasting Knowledge

• Promote transfer, and work with the student to analyze their thoughts and actions
• Memory devices and physical movement can help as well.