Applying Learning Theories in PDF - Healthcare Practice

APPLYING LEARNING THEORIES TO HEALTHCARE PRACTICE  LEARNING Learning: a relatively permanent change in mental processing, emotional functioning, and behavior as a result of experience. Learning Theory:: a coherent framework of integrated constructs and principles...

APPLYING LEARNING THEORIES TO HEALTHCARE PRACTICE  LEARNING Learning: a relatively permanent change in mental processing, emotional functioning, and behavior as a result of experience. Learning Theory:: a coherent framework of integrated constructs and principles that describe, explain, or predict how people learn.  CONTRIBUTION OF LEARNING THEORIES Provides information and techniques to guide teaching and learning Can be employed individually or in combination Can be applied in a variety of settings as well as for personal growth and interpersonal relations  CONTRIBUTIONS OF LEARNING THEORIES (CONT’D) Learning theories can be applied at the individual, group, and community levels not only to comprehend and teach new material, but also to solve problems, change unhealthy habits, build constructive relationships, manage emotions, and develop effective behavior.  CONTRIBUTIONS OF LEARNING THEORIES (CONT’D) Behaviorist, cognitive, and social learning theories are most often applied to patient education and healthcare practice. (Redman, 2001).  CONTRIBUTIONS OF LEARNING THEORIES (CONT’D) It is argued in this chapter that emotions and feelings also need explicit focus in relation to learning in general (Goleman, 1995) and to health care in particular.  CONTRIBUTIONS OF LEARNING THEORIES (CONT’D) Why? Emotional reactions are often learned as a result of experience, they play a significant role in the learning process, and they are a vital consideration when dealing with health, disease, prevention, wellness, medical treatment, recovery, healing, and relapse prevention. Ex: Diarrhea/Antibiotic Use/ Hypertension/ Healthy Diet  While not always treated as learning theories in psychology (Hilgard & Bower, 1966), psychodynamic and humanistic perspectives are included in this review because they add much to our understanding of human motivation, emotions, and the learning process. LEARNING THEORIES  Theories are compared with regard to: 1. Their fundamental procedures for changing behavior 2. The assumptions made about the learner 3. The role of the educator in encouraging learning 4. Sources of motivation 5. Ways in which learning is transferred to new situations and problems.  BEHAVIORIST THEORY Concepts: stimulus conditions, reinforcement, response, drive. To change behavior, change the stimulus conditions in the environment and the reinforcement after a response.  BEHAVIORIST DYNAMICS Motivation: drives to be reduced, incentives Educator: active role; manipulates environmental stimuli and reinforcements to direct change Transfer: practice and provide similarity in stimulus conditions and responses with a new situation  BEHAVIORIST THEORY Focuses mainly on what is directly observable, behaviorists view learning as the product of the stimulus conditions (S) and the responses (R). To modify people’s attitudes and responses, behaviorists recommend either altering the stimulus conditions in the environment or changing what happens after a response occurs.  RESPONDENT CONDITIONING Learning occurs as the organism responds to stimulus conditions and forms associations. A neutral stimulus is paired with an unconditioned stimulus–unconditioned unconditioned response connection until the neutral stimulus becomes a conditioned stimulus that elicits the conditioned response  RESPONDENT CONDITIONING Also termed classical or Pavlovian conditioning. Emphasizes the importance of stimulus conditions and the associations formed in the learning process.  RESPONDENT CONDITIONING n this basic model of learning, a neutral stimulus (NS) (NS)—a stimulus that has no particular value or meaning to the learner learner— s 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. Often occurring without thought or awareness, learning takes place when the newly conditioned stimulus (CS) becomes associated with the conditioned response (CR). RESPONDENT CONDITIONING MODEL OF LEARNING  RESPONDENT CONDITIONING Respondent conditioning highlights the importance of the “atmosphere” and staff morale in health care. Often without thinking or reflection, patients and visitors formulate these associations as a result of their hospital experiences, providing the basis for long-lasting attitudes toward medicine, healthcare facilities, and health professionals.  RC: SYSTEMATIC DESENSITIZATION Systematic desensitization - is a technique based on respondent conditioning that is used by psychologists to reduce fear and anxiety in their clients (Wolpe, 1982). The assumption is that fear of a particular stimulus or situation is learned, so it can, therefore, be “unlearned” or extinguished.  RC: SYSTEMATIC DESENSITIZATION Fearful individuals are first taught relaxation techniques. While they are in a state of relaxation, the fear fear-producing stimulus is gradually introduced at a non-threatening level so that anxiety and emotions are not aroused. After repeated pairings of the stimulus under relaxed, nonfrightening conditions, the individual learns that no harm will come to him or her from the once once-fear-inducing stimulus Finally, the client is able to confront the stimulus without being anxious and afraid.  RC: STIMULUS GENERALIZATION Stimulus generalization - Is the tendency of initial learning experiences to be easily applied to other similar stimuli. For example, when listening to friends and relatives describe a hospital experience, it becomes apparent that a highly positive or negative personal encounter may color patients’ evaluations of their hospital stays as well as their subsequent feelings about having to be hospitalized again.  RC: STIMULUS GENERALIZATION With more and varied experiences, individuals learn to differentiate among similar stimuli, and discrimination learning occurs. Spontaneous recovery -Although Although a response may appear to be extinguished, it may “recover” and reappear at any time (even years later), especially when stimulus conditions are similar to those in the initial learning experience.  OPERANT CONDITIONING Developed largely by (B. F. Skinner 1974, 1989), focuses on the behavior of the organism and the reinforcement that occurs after the response (Alberto & Troutman, 1990). A reinforcer is a stimulus or event applied after a response that strengthens the probability that the response will be performed again. When specific responses are reinforced on the proper schedule, behaviors can be either increased or decreased.  OPERANT CONDITIONING Learning occurs as the organism responds to stimuli in the environment and is reinforced for making a particular response. A reinforcer is applied after a response strengthens the probability that the response will be performed again under similar conditions.  CHANGING BEHAVIOR USING OPERANT CONDITIONING To increase behavior positive reinforcement negative reinforcement (escape or avoidance conditioning) To decrease behavior Non reinforcement punishment  OPERANT CONDITIONING The use of reinforcement is central to the success of operant conditioning procedures. 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. COGNITIVE THEORY  COGNITIVE THEORY Concepts: cognition, gestalt, perception, developmental stage, information information-processing, memory, social constructivism, social cognition, attributions To change behavior, work with the developmental stage and change cognitions, goals, expectations, equilibrium, and ways of processing information.  COGNITIVE DYNAMICS Motivation: goals, expectations, disequilibrium, cultural and group values Educator: organize experiences and make them meaningful; encourage insight and reorganization within learner Transfer: focus on internal processes and provide common patterns with a new situation  GESTALT PERSPECTIVE Perception and the patterning of stimuli (gestalt) are the keys o learning, with each learner perceiving, interpreting, and eorganizing experiences in her/his own way Learning occurs through the reorganization of elements to orm new insights and understanding  GESTALT PERSPECTIVE Another central gestalt principle is that perception is selective, which has several ramifications. First,, because no one can attend to all the surrounding stimuli at any given time, individuals orient themselves to certain features of an experience while screening out or habituating to other features. Patients in severe pain or worried about their hospital bills may not attend to well-intentioned intentioned patient education information.  GESTALT PERSPECTIVE 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.  GESTALT PERSPECTIVE Moreover, because individuals vary widely with regard to these and other characteristics, they will perceive, interpret, and respond to the same event in different ways, perhaps distorting reality to fit their goals and expectations. This tendency helps explain why an approach that is effective with one client may not work with another client. The gestalt perspective is one of the oldest schools of psychology and has trongly influenced a number of more recent cognitive perspectives. INFORMATION-PROCESSING PROCESSING PERSPECTIVE  INFORMATION-PROCESSING PROCESSING PERSPECTIVE The way individuals perceive, process, store, and retrieve information from experiences determines how learning occurs and what is learned. Organizing information and making it meaningful aids the attention and storage process; learning occurs through guidance, feedback, and assessing and correcting errors.  STAGES OF INFORMATION-PROCESSING INFORMATION PERSPECTIVE e first stage in the memory process involves ying attention to environmental stimuli; attention, n, is the key to learning. us, if a client is not attending to what a nurse ucator is saying, perhaps because the client is ary or distracted, it would be prudent to try the planation at another time when he is more eptive and attentive.  STAGES IN INFORMATION-PROCESSING INFORMATION PERSPECTIVE 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.  STAGES IN INFORMATION-PROCESSING INFORMATION PERSPECTIVE n the third stage,, the information s transformed and incorporated encoded) briefly into short-term term memory, after which it is either isregarded and forgotten or stored n long-term memory.  STAGES IN INFORMATION-PROCESSING INFORMATION PERSPECTIVE Long-term term memory involves the organization of information by using a preferred strategy for storage (e.g., imagery, association, rehearsal, breaking the information into units).  STAGES IN INFORMATION-PROCESSING INFORMATION PERSPECTIVE The last stage involves the action or response that the individual makes on the basis of how information was processed and stored. In general, cognitive psychologists note that memory processing and the retrieval of information are enhanced by organizing information and making it meaningful. STAGES IN INFORMATION-PROCESSING INFORMATION PERSPECTIVE MODEL  INFORMATION-PROCESSING PROCESSING PERSPECTIVE The information-processing processing perspective is particularly helpful for assessing problems in acquiring, remembering, and recalling information. Some strategies include the following: 1) have learners indicate how they believe they learn 2) ask them to describe what they are thinking as they are learning 3) evaluate learners’ mistakes 4) give close attention to their inability to remember or demonstrate nformation.  NINE EVENTS AND THEIR CORRESPONDING COGNITIVE PROCESSES THAT ACTIVATE EFFECTIVE LEARNING (GAGNÉ, BRIGGS, & WAGNER, 1992): 1. Gain the learner’s attention (reception) 2. Inform the learner of the objectives and expectations (expectancy) 3. Stimulate the learner’s recall of prior learning (retrieval) 4. Present information (selective perception) 5. Provide guidance to facilitate the learner’s understanding (semantic encoding) 6. Have the learner demonstrate the information or skill (responding) 7. Give feedback to the learner (reinforcement) 8. Assess the learner’s performance (retrieval) 9. Work to enhance retention and transfer through application and varied practice (generalization) COGNITIVE DEVELOPMENT PERSPECTIVE  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, organized, and represented within each person’s mental framework or schema schema—a framework that is partially dependent on the individual’s stage of cognitive development and readiness to learn.  COGNITIVE DEVELOPMENT PERSPECTIVE A principal assumption is that learning is a developmental, sequential, and active process that transpires as the child interacts with the environment, makes “discoveries” about how the world perates, and interprets these discoveries in keeping with what she knows (schema).  COGNITIVE DEVELOPMENT PERSPECTIVE ccording to this view, children ke in information as they interact ith people and the environment nd either make their experiences with what they already know ssimilation) or change their erceptions and interpretations in eeping with the new information ccommodation). SOCIAL CONSTRUCTIVIST PERSPECTIVE  SOCIAL CONSTRUCTIVIST PERSPECTIVE Learning is heavily influenced by the culture and occurs as a social process in interaction with others. A person’s knowledge may not necessarily reflect reality, but through collaboration and negotiation, new understanding is acquired.  SOCIAL CONSTRUCTIVIST PERSPECTIVE ntral tenets of this perspective are that: The learning process is influenced ngly by the culture. Effective learning occurs through social action, collaboration, and negotiation OCIAL COGNITION PERSPECTIVE  SOCIAL COGNITION PERSPECTIVE An individual’s perceptions, beliefs, and social judgments are affected strongly by social interaction, communication, groups, and the social situation. Individuals formulate causal explanations to account for behavior that have significant consequences for their attitudes and actions (attribution theory).  SOCIAL COGNITION PERSPECTIVE cial cognition, sometimes called otional intelligence, plays a major e in children’s social and emotional velopment. s therefore important to understand at it is and how a child’s vironment can affect the velopment of this skill. SOCIAL LEARNING THEORY  SOCIAL LEARNING THEORY Concepts: role modeling, vicarious reinforcement, self self- system, self-regulation To change behavior, utilize effective role models who are perceived to be rewarded, and work with the social situation and the learner’s internal self self-regulating mechanisms  SOCIAL LEARNING DYNAMICS Motivation:: compelling role models perceived to be rewarded, self-system system regulating behavior, self self-efficacy Educator:: model behavior and demonstrate benefits; encourage active learner to regulate and reproduce behavior Transfer:: similarity of setting, feedback, self self-efficacy, social influences  SOCIAL LEARNING THEORY According to early social learning theory, much of learning occurs by observation—watching watching other people and discerning what happens to them. In health care, social learning theory has been applied to staff training and to interventions that address public health problems such as teenage smoking and alcoholism among the elderly (Akers, 1989, 1996).  SOCIAL LEARNING THEORY First phase is the attentional phase, a necessary condition for any learning to occur. 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. Fourth is the motivation phase, which focuses on whether the learner is motivated to perform a certain type of behavior. SOCIAL LEARNING THEORY PSYCHODYNAMIC THEORY  PSYCHODYNAMIC THEORY Concepts:: stage of personality development, conscious and unconscious motivations, ego ego-strength, emotional conflicts, defense mechanisms To change behavior, work to make unconscious motivations conscious, build ego ego-strength, and resolve emotional conflicts  PSYCHODYNAMIC DYNAMICS Motivation:: libido, life force, death wish, pleasure principle, reality principle, conscious and unconscious conflicts, developmental stage, defenses Educator:: reflective interpreter; listen and pose questions to stimulat insights Transfer:: remove barriers such as resistance, transference reactions, and emotional conflicts  PERSONALITY IS MADE UP OF THREE PARTS: THE ID, EGO, AND SUPER-EGO: SUPER The id is the primitive and instinctive component of personality. It consists of all the inherited (i.e., biological) components of personality present at birth, including the sex (life) instinct – Eros (which contains the libido), and the aggressive (death) instinct - Thanatos.  PERSONALITY IS MADE UP OF THREE PARTS: THE ID, EGO, AND SUPER SUPER-EGO: The ego develops in order to mediate between the unrealistic id and the external real world. It is the decision making component of personality. The superego incorporates the values and morals of society which are learned from one's parents and others. Parts of the unconscious mind (the id and superego) are in constant conflict with the conscious part of the mind (the ego). This conflict creates anxiety, which could be dealt with by the ego’s use of defense mechanisms. PSYCHODYNAMIC DYNAMICS HUMANISTIC THEORY  HUMANIST DYNAMICS Motivation:: needs, desire to grow, self self-concept Educator:: act as facilitator who respects learner’s uniqueness and provides freedom to feel, express, and grow creatively Transfer:: positive or negative feelings and choices as well as freedom to learn, promote, or inhibit transfer  HUMANISTIC THEORY Learning occurs on the basis of a person’s motivation, derived from needs, the desire to grow in positive ways, self-concept, concept, and subjective feelings. Learning is facilitated by caring facilitators and a nurturing environment that encourage spontaneity, creativity, emotional expression, and positive choices.  HUMANISTIC THEORY Cornerstones of Humanistic Theory Approach: 1. Importance of emotions and feelings 2. Right of individual to make their own choices 3. Human creativity Listening ---rather rather than talking talking– is the skill needed.  HUMANISTIC THEORY Humanistic Humanistic Theory contends that feelings and emotions are the keys to learning, communication, and understanding. Humanists Humanists worry that in today’s stressful society people can easily lose touch with their feelings, which sets the stage for emotional problems and difficulties in learning.  HUMANISTIC THEORY The The humanistic learning theory has modified the approach to education and changing behavior by giving primary focus to the subjective needs and feelings of the learner and by redefining the role of the educator.  GENERALIZATIONS ABOUT LEARNING Learning is a function of developmental changes Brain processing is different for each learner Learning is active, multifaceted and complex Stress can interfere with or stimulate learning  ENVIRONMENTAL INFLUENCES (EXTERNAL) stimulus conditions and configuration of elements social and cultural influences role models, experts, and guides reinforcements feedback  LEARNER INFLUENCES (INTERNAL) developmental stage ways of processing habits information perception memory storage thoughts and reasoning schema  LEARNER INFLUENCES (INTERNAL) conscious and expectations unconscious motivation goals self-regulation needs subjective feelings self-concept  HOW TO PROMOTE CHANGE Relate to what learner knows and is familiar with Keep experiences simple, organized, and meaningful Motivate learner (deprivation, goals, disequilibrium, needs, tension) May need incentives and rewards, but not always  How to promote change Experiences must be at the appropriate developmental level Make learning pleasurable, not painful Demonstrate by guidance and attractive role models  HOW TO MAKE LEARNING RELATIVELY PERMANENT Relate experiences to learner Reinforce behavior Rehearse and practice in variety of settings Have learner perform and give constructive feedback Make sure interference does not occur before, during, or after learning  HOW TO MAKE LEARNING RELATIVELY PERMANENT Promote transfer Have learner meditate and act on experience in some way (visualize, memory devices, discuss, talk, discuss, write, motor movement) Checkpoint! Prepare for possible questions/pop quiz/ recitations/seat works/assignments QUIZ (ESSAY) 20 POINTS POINTS- ½ CROSSWISE 1. Why are some theories more effective with certain individuals than with others? 2. If you were to choose a specific theory for personal learning what would it be and why?  ASSIGNMENT/LIBRARY WORK: In a tabulated form create a summary of the different learning theories. Specifications: Arial Narrow/ Times NR (Font Style) 12 (Font Size) Use LONG Bond Paper/ Landscape (Page Orientation) Must contain a Front Page Cite your references NOTE: Submission is on ____________________