Nuegets of wisdom

•rn your ffllkavors,present 4'l'Ulfa.tv:re,remmwer

to liave tfie courage of-yum'Cbl'lvictimlS •.
• Haywood sum-

CHAPTER IV
Applying Learning PriDclplea and
Theories to Healthcare Practice
l, What ia Leaming?
Leaming ia a relatively penn1U1.ent c~e bl mental
proceMhll. em.otlcmal tanctlonma: and/or behavio, as a result
of a:perlence (Butable, 2003), Leanun& is a lasting or
permanent ·change tn beluwlor as a resuit 'of e,cperlencc which
is primarily determined or influenced by the environment where
the person is -situated, It is a complex process which involves
changes in mental processing, development of emotional
functioning and social transactional skills which develop and
evolvefroin birth to death.
,, ;2.. How doea teaming oceur?

Leaming ocean aa the Individual Interact• with his/her

e1a'9UOIUll.ellt aad Incorporates or appllea 11.ew lnfonnation or
a:periencea to what he/ahe already lr:Dowa or baa teamed.
Several environmental fac:ton affect learahag like society and
culture, the structure or pattern of the stimuli, the effectiveness or
credibility of role models and reinforcements, feedback for correct
and incorrect responses, and opportunities to process and apply
learning to new situations- (Bastable, 2003}. Learners also have
their own way of takinc hl -d pro.ceaaing Information
{1eanlJng atylea) and the type, m.ture and level of motl-t~n
aJao affects learlllne,

; . What kinds of experiences facilitate or hinder the learnlnc

proceaa?
a. the teacher's &elec:t!OD of leumng theories to be
applied and the struct1:lrl:Daor type of learning experience are
very important considerations;

71
 b. the teacher'• lm.owleqe of the nature of the lea.mer,
tlle matertai. to be Jeanaed, teacbille methoda to be
-ployed, commUJllcation eldlJa, -d ability to motivate the
lea.mer;
e, tlle teacher's abWty to relate new bowledg• to
pre'riou.aacpenen-, values, ae1C-pereeptlo11 -d tlle leam.er'a
reacUn.eaa to team are ai.o some or the -Y racton tbat may
filcllltate or Jwuter J.earn1nt.
I. COJIIIOI\I PRI1'CIPLES OF LBARJIDIG r~ ,.,
-,-.

There are ten (101 learning prlnd,pfu that can help

m.otiflate the leamer (de Young, 2003). Among these are:
a. U.e _, -. When. dealing wi1h the question of
how much people are able to retain what has been learned, it has
been shown that people retain 10% or what they read, 20%·'0f
what they hear, 30% of what they see or watcb, 50% of what
they aee and hear, 70% or wbat they aay, and 90% of what
they aay and do. This is shown by the Leaming Jilll:perle11ce
Colle below.
our Level of lnwlwment: ,

10 % <ii What.we read

~ of what we heer
3~ o!-wh~twe·i,es::

50% of >lhat we Watching a film or

see, he.er or read video

70%ol'what Pattietpating in a diecu.:s8k)ll

weay
Making a presentation
ParticipatiJ>!l In a role:-Pb\Y

90 % of Simulating/~oing the real thing Doing

what we/-~~~~~~~~~~~~~~~~~~~~~
both aa;r Dom& the real thing
anddOL-~~~~~~~~~~~~~~~~~~~~~~~
Fig. 6 THE EXPBRIBKCE COMB
-.- ... 1989. - to Dewlop and ...... tatall"Tnlalnc co-.
72
· This is the importance ofthe RLB {.R41rm- U(ll'Rffl(I Bqcrrfencu
J
which nursing students undergo in the Nursing Skills Laboratory
where
• they are made to Imitate the procedures that are
demonstrated by the instructors (role-modeling), and,
• are paded according to the u:Ws they exhibit and the
dep-ee or comi,tehesmon ot the raUODalebehind the
Ste:{)s in the procedures as they perform the return
demonstration. It ii expected that by Imitating, they
would be able to ntaln 70% of the le1son.

By applying the" 11dlle and knowledge in the actual

can, of patwnts In the hoapttal, this would be further
reinforced by additional practice and review of the principles and
procedures and the extra care and caution in their application and
performance resulting to 90% n1tentio11.
b. Actively involve the patient. or clleutl in the leanlinc
procen.
• Use more interactive methods involving the participation of
the learners like role-playing, bues sessions, Q & A
(question & answer) fonnat, case studies, small group
diacusaion, demonstration and return demonstration.
e, Pro,rtde an en'fUOJllllent co11duclve to leam1ag.
• Always consider the comfort and convenience of the learner
{room temperature, the chairs and seating arrangement or
space, noise level, adequate acoustics and sound system,
and an environment that is clean, pleasant-smelling and
smoke and dust-free. ·
d. Aue• the extent to which tho learner la ready to learn.
• Readiness to learn is affected by factors like emotional
status (anxiety fear, and depression) and physical
conditions (pain, visual or auditory impairment,
anesthesia, etc.].
e. Determille the relevauce otthe lnformatioll.
• Anything that is perceived by the learner to be
important or useful will be easier to learn and retain.
 f. Repeat the illform.atlo11.
• Continuous repetition of information over a period af
time enhances learning; applying the information to a
different situation or rewording it and giving practical
applications will help in the learning prooess.
g. Generalize I.Dformatlo11.
• Cite applications of the information t<. a number of
applications or situations.
• Give examples which will illustrate or coneretize the
concept.
h. Make leanwi.g a pleasant ezperience.
• Give frequent encouragement, recognize accomplish·
ments and give positive feedback.
i. Begin with what la lmown; move towardthe Wlbcnrn.
• A pleasant and encouraging learning experience if
information is presented in an organized manner and
with information that the learner already knows or is
j! familiar with.
j. Prese11t l11formation at an appropriate rate.
• This refers to the pace in which information is presented
to the learner... are you talking too fast so that the
learner has a difficulty in catching up with what you are
saying or are you too slow because the learner is already
knowledgeable about the topic you are discussing?

4. What helps enallff that learning becomes rehltlvely

permaneat?
a. by organi:aring the learning ezpertence so that it becomes
meani11gfal and pleasun.ble; and by presenting the
information at the leamer'a pace to ensure etfoc:tive and
emcient proceumc of information;
b. practic:iJI&' or reheaning •- iafOJ'Dlation mentallv or
_physically to retain and atreDgthea learDing;
e, applyiag reinlorcemeata through reward8 or reoognltiou
·to make the learner Im- tlaat leamillg baa oecuned;
d. uaeadn& or eval-tlng wlaether leanung has taken place
immediately after the nperiellce or some later point Ill
time. An evaluation feedback can be used to revise, modify,
revitalize or revamp the learning experiences.

74
 n, LMRNING Tll1!lORJES
A fecu;ning theory is a coherent hmework and aet of
mtepted construct. and pliuciplee that describe, npJafa or
piedlct how people learn, how leamlng ~1ln, 1111d what
motivate• people to lelU'Dand change (Bigge & Shermis, 1992;
Hilgard and Bower, 1996; Hill, 1990). Some issues like how does
JeanalPa:take place, what e.aav.re sue- or ooatribute to
failure ID leanaf.Q& and what are the o'bstaclea to le1UD1a1 have
been the concern of educators and educational psychologists.
Leanitng theories, teachinl ud learning tecludquea and
strategies based on sclentlftc studies and prlnolplea and
--•at and evaluation technique• have been given mon
emphallfs la what is now the tread of "meJ1.torlag the mentor"
or "training the tralaer"

EDUCATIOWAL PSYCHOLOGY AS BEUfG RESBARCB·BASBD

• The start of the twentieth century saw the emergence of a
new field known as Educational Psycho~ which
became the catalyst for the scientfftc study of teachla&,
leamiPa: and assessment (Berliner & Calfee, 1996; Gage
and Berliner, 1998; Woolfolk 2001). As such, it la
concerned with systematic eviden<:e and data-ptherinl
which are used to test theories and Jlypotheaes about
leam.in1.

Why The Health Professional Need&To

Know The Nature OfThe Leamer

• Leaming theories put together coil.cepta and

propositions to explalu "why people learn and
predict under what circumstances they will lea,n"
(de Young, 2003).
• There is no single theory that can be considered u the
beat answer "to these questions. The deflalt1on of
learniDi generally depends on the perspective of the
leam.ing theory that ia being used.

Coatrlbutfons of Leaming Theories

1. learalac theories have helped us understand the
process of teachJDg aAd leatDing or how fDdh,fduaJa
acquire knowledge and chance the way they tb.111.k. lilel
and 'behave;
75
 2. In the practice of bMlthean, these theories ba'N
helped the bealth. profeAloula to -ploy IIOIUUI
metho~ _, naUonalM bl. their belllth edac:atm
etrort. · bavolvtq patients/ cUent.a, staff tnfntq uul
educ:atton and m ~ out contlllutq he&ltll
edu.ca.don and promotion propama.

To -dentand tl.e -tue of the leanler, the health

professional needs to know some 'bulc prlD.clplea bl.votnd fa
the deftlopment -d maturation of the 111.dlvidlUII. Bwmen
Development is the d.y:llamtc proceu of cbaqa that occurs In
the ph)'lllcal, pa:,cbolopcal, aoclal, apiritl:ual, and -ott-·•
constitution and make-up of an individual which atuu ftom the
time of cOllception to death (from womb to tom'b). It is the
scientific study of the changes that occur in people as they age or
grow older in years. ThMO cben1ea may entell:
l. growth which is quanfftatiw involving incnN:iN ·in the
.,_ oftlw parta of the body . .
2. dewlopnMlftt which is qualttattw involving gradllal
changes in charactu

All the per9on grows &Ad develops, two (21 ~

proc••••• take place whicb are:
1. Leanilng- Any relatively pel'lllaD-t cbmip fa
1'elamor 'brought about throup experi-ce I
2. llaturatton- bodfl:y change#J which are primarily a
result of heredity or the traits tl;lat a person inherits from his
parents which are prwtlaallg ~ Prepro,nuiaaed
111.11.erited biological pattern• are ndJe<:ted ID meturatlon.

The 5 ~r leanwlg. theorlu that are widely uecl fa patient

ectacatton and health care practice are:
a. S.havloriet
b. Copltive
e, Soe1al leanam.g
d. PllydaodyDamlc
e, Bvmantwtlc

76
-
)11

I, BJ!:IIA.VIORIST
TBE)ORIZSOF ~G
Jolm B. Wat.son is the proponent of Qeha.viorist theory
which emphasizes the .importanee of observable behavior in the
1tud;y of human beings: He defined behavior as muscle movement
and it came to be associated with . the StJm'llhul-RllapoNe
,-,ol&oloa. Hepostulated. that k"--lor rdutt. from a .wrfer
~ condltl-«I n,Jru- and that au CfflotioM and tltoutl"'-

-
~th - a_pndlu:t of hflao(or ream.cf through COJUffl'lonfnf, (de
II la Young, 2003/.
• ~I, then, I.ti a result of th• conclltloaa or atlm1111 (81
in
I'll In tll• •nvhonment and the lear,au•a rNpolllM (]l) that
oul follow, Thie is known as the 8-R model of learning or the
I the atlm:alu· naponee theory.
I the • Behavioral scientistsusually ohllerve the nsponau ud then
ge or -'Jl1llate the environment to bdng abo11t tile dae1Nd
ob•n•· (Hilgard and Bower, 1996; Blgge & Shermie, 1992;
\ tlv Hill, 1990).
• To bring about the intended change in the attitudes and
reaponees of the subject, 19,ne •ttm,U Ip tilt tPY!rTMUS
N! alwnd or the eft'eets OJ COllf!Q!l!ROff of I AIMPN la
cb•nr4,
• llottwdoo to cb•nce la brought about 1,y tJae clealN to
Nd11ce some drive or DRIVB-REOVCTl01'
• la Consequence: Sattefted, complaoeot or satiated lacU.Ylclaala
have little motivation to cbaJaae and learn.·
ily "4
• For this belaa.tor to be applied or tru.dernd. from the lDttlal
n hie leualas altli&Uon ~ other eettlap or droamstaacea ia
amed possible throqla JDCS;lct or fwmetlop gt ha)lta,
BeJaavtoral learnlDI is based on .respondent condltlonlnl ud
1Uent opaaot oaa~ piooedmea.
A.l, RE8P01'DUT COlO>lTIOlllll'O
1. 9tnJqpJ g_~_M condttionlna- a ~ wJakla
taa-OM tJae acciv.llltion of new napo11N11to enwb:aameatal
.tlm.U:
~ a neatral •timahaa (1'81 elloltll aa uacoadltlaal
napoue (VCR) tJuoqb repeated. plllnap wWa -
--"tioaed •tlmalu (UCS). A neutral stimulus (NS) ia
a stimulus that bas no particular value, aignfficanoe <II'
meaning to the learner. Wiien tile 1'8 .. ~ ,-• ell

77
 Ct .1 .. ,,.,., •• .....,, I \I ---~- :IOU

with tllc 1UlOOlldftioned lltmlal'IUI rues, aad the

-0011ditioncd reepoue (UCR), there comM a tbne
"h- the lf8, e,ren wlthOllt the OCS, elidta the -•
UCR.

Srl'UA'nONAL TLLUSTRATION: Cecilia Belle, a pretty and lively

three-year old, accidentally touched the flame (ffS) of the candle.
She felt intense p&ia rues,
and 41uJckJy withdrew her haad
[UCR). Two days later, the same experience happened and part of
her finger WM burned. Consequently, the flame of the candle
(lf8) came to be associated with the pabi. (UCSI that, -eD la ita
alNtenoe, Jut the aigbt ol the Oame 11111kes her wtthdra" her
haad. Hence, the 11eatn1 etimulm (!18), which is the flame, bas
now become the c-clitioa.ed etimulue (CS) and the automatic
withdrawal of her band has become the Jean:ed reapoue.
• Principles of reepondent condttlonlD.g may also be used
to extb.pJeh a previou.ly learned reapoase:
Leamed respo- may eVfll.tually be unlearned If the
occanence of a CS bl not accompanied h:, the UCS for a 1on1
period of time or tatc"111.

:;i. s,.tematic deaenaitiaati- is another technique ha.sed -

reepoedent colllditlonlog which is widely used in psychology and
even in medicine to reduce foar aad amdety ID tJte patient
(Wolpe, 1982).
This is based on the principle that repeated and gradual
expoelU'C to feu-tadachlg stlmulu wuler relazed and non-
~ cbewnatar:cN will glve the patient that aenae of
MCUrity that no harm will come ao that he or ahe no loqer
feua the ettmulus.
This is also a atrea-recblcln1 atratec:, that is adapted to
help ,noperatlve patt-ta, rehabW.tathlg chug addicts -d
teulon headache• ud phobia&, among others (Bastable, 2003).

3. Sttm:011111 ,eaerallatioii is the tendency to apply to other

ebnOar etfmali what - butially learned.
• Dlecnmiltation leal"lllne develops later when ftried
qperleD- ff9Dtualfy •-bJe the individual to
cWlienatiate -osaa •llllilar etbnuli.
• Discrimination learning is oftu. iD-'"4 in
prof,tNlollal echacat!ola -d clinical jlraCttce.

78
4. Spontaneous recovery ill usually applied in rela,-e
pNVOation proaram• (rpp) and may explain wily it la quite
difllcu1t to -mpletely elimtn'ilte -unhealthy habits aad
addictive beha9iors (alcoholism, drug abuse, smoking) which one
may claim having successfully "kicked the habit" or extinguished
it only to find out that it may ncovcr or ~ppear uay time,
nen year&-later.

A.2. OPERANT COJfDITIOlffl{G

-developed by B.F. S>rtaner which focaaea on the

1Mha9ior of the orpniam and the relllforcement that foll-
dt.r the reeponae (Alberto & Troutman, 1990).

Reinforcement. are event& that strenathen reapoD.Sea. It is

one of the most powerfal tools or proceduffa uaed in teachl.nJ
an.d la a ml!Jor condition for 111oat learning to take place. Its
beginnings are traced back to Thorndike's Law of Effect (1911)
which states that:
• •or. several 1'CSJIOIUI" made to the -e .
ait-tioa, those
which are accompanied or closely followed by aatiafactloa
will, other things being equal. be mon, Onnly conaected with
the aituatlon so that when the situation recun, these
responaes will k more likely to recur;
• those reapomea wluclvare accompanied or cloaely (ollowed
by cl!scomfort will, other things being equal, have their
connections with that situation weakened, so that when the
aituatlon recurs, the reapoaae will be leN likely to recur.
• A rein.forcer is a stimulus or event that la pven, applied or
elicited after a respoDSe to strengthen or reinfoiee the
possibility that the response will be repute~
• When specific responses are reJnlotced on a proper ached1ale,
the behaviors can be Increased or do<:reaaed.
trample: The child who ts given a podtivo re~meat lib
a reward or praiae every tt,ae he/she -.eels in school wm be
eacouraged or motivated+ ... JIUIUltaia tll1a behavior.

79
 ca..e;+!:fl!ir!!ll•mt,Pa
t L' _., .. '°""'' oPt tlM ao11

Operant Conditioning
• Leaming In which the
coneequenoes of .i-
behavior lead to
changes in the !··~
•
probability of its
OCCUITence.
t:.
j In>

• Thomdike'a puzzle
bo,c
• ..
...... ,,

•
l'I&· 7 Tbomdllie'• 1'11sa1e Bcm

a.lafonleme11t ill Leam.1111: Tile t.acller mut lmow 1'11.at

behaYion uoukl be reill.fOteed.

Positive Reinforcement
• Any consequence of
behavior that leads to
•n Increase in the
probability of its
occurrence.
• Timing
• Consistency

80
 Clept .,,.,..,......... 'ft , te Beeht • l'rM:tlol •11

fleltcfftt fll ,.we,..,. ntfr\(orcement l,g Ve,p'-ck (1955} HHCllf

that:
• In 'Nrbelfntlon of oplalona: each time the student says •1
believe" or
"I think that" .... and the experimenters would nlalorce these
by saying "You're right" or •1 agree with you", or they would
smile or nod, the atuclente wollld YOluat..r their opfnfoll1
amereadlly.
• when nilnforcel'II -re wttlldra- and the answers were
ignored or statements like • I oe~ disagree with you on
that", the DIUllbel'of oplnl.on atatementl by the 1tadMta
abuply clecllDed. Andenron, W'htts and IVaslt (1966/
eollduct«f •tuda, Nrtat.«I to ac:a q/ prauln// -.
,win-ft

•• B:naothe, .. :
H, Pra.l.Nd students will perform better than rep.roved
students
H2 Repaoved low acllleven and pniNd bfC1a
acllieven will perform bettu than pralnd low
acblevel'II ud reproved bJ.ch acllienn.
b. S.bjecta or the atv.dy: v.nlvenlty 1tudenta emolled ID a
aoune iD educational peycllolou
Teetlq • evalutJon: AD objective tfft of the subject
matter wu cl'ffn aa criterion test and an objective test in
rn?thematics was given to detennine if behaviors would be
transferred to a different stlbject area,
a. RNulbl or the Study:
There was pe.ter achievement lncremeat ID
perform.a.Dee affectlnc educatloD&I peyolloJoa -d
matJaematlos ~ pralH rather than npn,of with botJa
the low achlevtq -d the hip ac:Jaleviq at1aclenta.

APPLICATIOR TO IIBALTBCARE/DIPUCATI01'8
OJr THE 8l'ODY

1 ,...... may aulat ID the tnn.rer of learalnc from one area to

mother.
~ Leaming -•r
the control or re~ is usually preferable to
aming under the control of punishment (Hilgard, 1956).

81
 C.pr:4;4ft .... J.eandSPtl t,f I..._ TlilcldN ID Peelthe"' Ptw;:tiw, 3011

Wa:,s of l'.mplo)'iq .Pwi..tttve Reinforcement:

1. Venal_,._
• Saying praise words or phrases like "geed", "well-done"
when the student responds
• Statements like "'lb.at was a well-expressed opinion" or •1
like the way you answered the question of the patient's
mother" are morale-boosters.
• Requesting the student to share his success story with his
classmates. This gives recognition to the student and
increases level of prestige with his classmates
2, lfon-ndllll wap like nodding. smiling, looking pleased,
writing student's comments on the board, and giving the "thumbs
up" sign especially where group work is concerned.
3. Citiq ID cJaes or publishing on the bulletin board exceptional
works or outputs
Claa&Uication of IW-dovl Relnforcen (Tosti end Addison 1979):

1. RecopitioA- includes
• praise, certification of accomplishments
• formal acknowledgements (awards, letters of reoommen-
dation, testimonials
• informal acknowledgements( private conversations, "pat'
on the back
2. Tanga"ble reward.s-Gftdes, food (free bmch), prises,
certificates of appnciation or citations
3. Leanuug actlvltle.- opportunity for desirable enrichment
assignment like membersbi.p in "honors" class, more interesting or
more difficult clinical. assignments
4. School ieaponaibllltiff-
• Opportunities for increased self-management and more
participation in decision-making
• Acceptance of suggestions for im_provingthe curriculum
• Greater opportunity for selecting own goals for learning
experiences
• Greater opportunity to control own schedule and set
own priorities
S. Status IDdicaton-
• Appointment as a peer tutor
• Having own space (study corner, desk)

82
6. Incentive feedback-
• Increased knowledge of examination scores
• Knowledge of individual contributions (helping others)
T. Penoual activities-
• Opportunity to engage in special projects
• Extra time off
lfOTS: Remember that reinforcements should be appropriate
or directly linked to the teaming tasks and .tudent's
accompllabment. Its indiscriminate use may result to happy
st1ldenta .but not to productive students (Tocti and Addiaon,
1979J. Ncpt1ve reinforcement is tantamount or SYJ:lODJ'lllO'lll
to punishment, Behaviona may be decreased through:
• rtonft!U\(on:ement by Ignoring the behavior, (whether It I.I
de,lrable or UlldealrableJ
• or applying punishment t,,,,_dfately ~r the ntap4>rue &
ffllUt be consistent and at the highest "reaAronClble lewL
Cardinal n.i.le of Operant condfflordng 18 to punish the
behalltor, not the person".

II. COGNITIVE THEORIES OF LEARNING

Cognition is more than knowledge acqul.lltlon. ll atre .. e,

that mental processes or cognition occun between the •
lttmulu, (S) and the reaponse(R).
• The learner's iOala and o:pectatiooa are more important
and the tenllion, dilequ.Wbrlum and imbalance that they
cauae which will act as their moUvatona.
• Transfer of lea~g occun when the teamer mediates or
"act, on" the information he/,he get• or applies It J.n
certain aituationa.
• It involves Intelligence which is the ability to aolve proble11111
or faehion product& that are Vlllued ID more than one
setting.
• lt .tre.uu the importance of "what gc,es on tnsfde the
learner'" which uuio!Pe., the indtoldual's cogn.tttve
procews of perc,,ptfon., thinking skills, rru,mory, and
ways of processi.n.g and stnlcturing i,iformatwn
(Pall.nacar, 1998) Uke:
• perceiving the information;
• iDterp:retinc it baaed on what la already known, and,
finally,
 a. reorpntct111 the taformation to come up with a.-
inafgbta or undenta.nding.

PJtR8PBCTIVB8 OF THE COGNJTIVE Ll:ARIIIltG I B&ORY

/ (Butable, 2003)

I. Geetalt- refers to the configuration or s-ttaned

orpnlption of cop.lttve elementa retlect:lq the m--«m that
the "whole ta greater than the aum of lta puta,..

The 1••talt penpeottve empbaat•e• the lm.portwnce of

perception ta leambit wbtch rocuae. on the conftamat!oa or
orpnlAtion of a pattem or atimalua. Look at the f1c11ff
below.

What do you aee? .\ff you NafJl& the ftpn or th•·

baclqp'ound? What did :,011 ftrwt eec •. .a :,OUlll lady or an old
-aa? Which wu cuter to nc.-tn ...the :,OUlll ladf or
theoldwomaa?

A YOUJl'GWOIIAII OR A1' OLD LADY?

84
._. prlllctples of Gestalt wllJch are related to healthean:

1. P9Jcholoaical o,paJ-tion ia dincted toward •lmplioity,

equillltrhuD.and ngvlarity.
Example: Give the patient a clear and simple explanation of his
diseased condition to allay his fears and uncertainties.
2. Pen:eptloa .. eelectlve which means that no oae can attend
or pay attention to all the aurroua.d.lng stimuli at the ame
time. An individual normally orients himself/ herself to
particular stimuli and screens out other stimuli which is
similar to fine-tuning of perception.
s. Wbat hldl'Yidaalapay atteAtloo to or what they ignore may
be afl'ected by fa.cton like Jl_da, penonal mot:JVN, :,aa't
ezperJences and the particular atnacton of the attm.uJ:uor
llituation.

Example: A patient who is in pain or is worried about the

_payment of lris/her hospital bills may give very little attention to
:be health teachings that the nurse is giving because at the
moment, that is not his/her primary consideration.

IIIPLICATIO
I{S TO HEALTH CARE
Knowledge of this gestalt principle will help the health
educator on how he/she approaches any learning situation with
ao individual or group. One approach may be effective to a
particular client or group but may not work with another.
Elecause individuals vary or differ from one another, the way they
;:,ettcive, interpret and respond to the same event may be :in
different ways and manner.

II, IDform.atton-proc sing is a cognitive perspective that

emphasizes the thinking processes like:
a thought
b. reasoning
c. the way information is encountered and stored
d. memory functioning
~ perspective is particularly useful for assessing problems in
acqu.iring, remembering and recalling information.

85
 Clla~r 4.&ppiy!Dc1-mill&l'rf>:olpke u4 ~ to a..wic.n.Pnctlce :ilOll

4 in the memory proceas:

1• atace: involves paying attention to the
ellViroamental stimuli; Attention is the key to leandne.
Knowing this prlnclple wW help the health pn>fesaionaJJI to
avoid aome pitfalls or diffl.cu.lttes when giving health
teachings.

Example: A mother 'who is experiencing intense pain from her

operation will not be able to pay attention to the nurse who is
demonstrating the proper positioning for successful nipple
latching. Her attention will be focused on the pain since this is
the stronger and more dominant stimulus.
21>11 stsge: the information la processed by the senses.
The client'• pireferred niode of sensory proceesmg which may
be viaaal, auditory or motor manipulation maat be conaideted
by the health educator.
3"' sta&e: the information is ttansformed and
Incorporated or eneoded briefly fnto short-term memory end
later may be disregarded or forgotten OT stored in long-term
memory by using strategies for storage Wee Imagery,
auociation, rehearsal, chnokiog !breaking the hl.fonna&n
into smaller units or chunks).
4u. sta.&e: involves the action or response that the
individual maltea on the basia of how the information wu
proeeued and 1Jtored.

m. Cognitive Development I• a third penp,ctive that

focuses on qualitative ch.a.ages in pei:celvtng, thtnldag and
reasoning aa Individuals mature grow and mature (Baltes et al ,
1999). ( ?t ,
Jean Plagf!t......ii the· best-known cognitive developmental
theorist. By watching, listening and hearing children ask
questions, Piaget found out children's perceptions at different
ages and' 'he identified four sequential stages of cognitive
development.

86
 ~GET'S rouR MAJOR PERIODS o, COGJOTlVB
L___ Oil llffELLl!:CTUAL DJl:YELOPIIBIIT
J. &maorlmotor ~: Btrth up to 2 years old· this is
determined basically on actual pel'HptiOll of the senses and the
atemal 01' phyaical taeton. Cbfldren Wnk due to
coordination of aenaory input and motor naponaes.
• lDt.elUgence is not1.-verllal or non...,..bolic because the
\ child has not developed lancaage yet.
• How leamin1 tabs place depeads on what S.
cuq,erienced kl the lleglnnfng which can be learned
ttuouch v1aua1 pllff11ita.
• This will later be Jmown as "oltJect pen,taMnce (what
end where it is seen for the first time will still exist even
though it disappears,
• I( marks the 4-elopment of memDf1I for the nursing
oldect who is usu.al~ the mother.
2. Abstract thtnkut.g: represents reality using aymbola that can
lie manipulated mentally.
Ex: symbolism in bible stories; use of X in algebraic
expressions
- Logical thinking is more systematic; uses scientific method ·
3. 1llformal operations, •,-npeetive thought" or relatl'riam is
formed which is a new pen)MICttve or other people poae••lnl
ftried thinJd:u.&on the same atillualua or attv.atk>11. There is
awareness on d.ifl'ennt vieW11 rather than on one •Ingle
tlaoqht.
• It ncopize• llldtvi.dual dlff'ore11cea & that •!fo two
iluUviduala are alike".
4. AAlmilatioll a. Accommodation-characterized by hypothesis
i=t:ing... be(on maldq conclmona, things nui.at be teated
with logical pieces of evideace •••ill search of truth.
• Being "teena&9n" al this stage, they have their .._
mind. Known as m.etucognttton (aelf-reffectlonl wherein
ideas and imaginations are tried out to be aware of existing
realities; also known as hatenaal dleJogue)
• "Billperieu.ce 1s the beat teacher" where aelf-conectloll In
eolvfng prolllem• ta applied.
• Vndentanda that "!fo two ID4ivicluala ~ alllte".
 ci.e•!fJ1y.,·l1 .... P:tl oa,,,, ... ,,..,.... .............. t:IN 3011

DI. SOCIAL LBARJURG THJ)ORIBS

• Bmpbylse the fmportaaoe of enYllonmental or attuau-1
detemdn1nta of behavior and their cODttn'llinCuateractloD.
Reciprocal Detenninilm by Albert Banchaft states that
"en.v:lronmen tioluL__ shape beha,:ior t.~
, end the penon'a behavior, In ret'llnl, Abapea the
emroament•.
• hrtber bellrm that behavior need not be pe1fo, med CUld
Nt,iforoedfor 1Mlrnbtg to occur.

Modeling or obMrvatlonal learnJll& occurs vfcarlouly, even in

infants, where the mdi'ridual learna of the consequence• of a
be!aavlor by ob.erving another person undeqofq the
-,erteace.

Four (4) O.Pfi '*"- ittPOlved in IIIOdeltng cuw: ..

1. attentional proceue•· which determine what a person can do
and what he or she· can attend to
2. ntentiow procenea- which determine II.ow acpertenee is
-coded or retained tn memory
3. motor reproduction procenea- determine what 1lehuior can
be performed
4. motivational & relllforcement proce-- determine the
circumstances under which leanatnc ii tnu.Jated Into
perl'onnance.

HOW BEHAVIOR OCCURS (BAl'fDUR4):

There are 3 interrelated detenntnanta of bellavior wlllolt

are anteoedenta, conaeguenoe. and .....,.1ttve facton:
"-'havtor is based on the put (antecedeu.ta) as we have
seen it, but it is also tnOuenced by lta nault (con1~11ence) and
how we are .moti,,.ted (copithe factor).

The tlOdal learnlq tlleory of penoll$Uty developeu.t by

Bandura unmea that all actual behavior pattenaa must be
leanled through traditiou.al leamf.u.& (by telaforcemeatl aad
obaenatiou.al J.eanatng (by modeling). It emphasizes the role
of mwlellng and other types of learning with DO direct
rewuda or reillforcemen.ta. lutead. bellaviQr la uaped
88
 Clule".4:'Pfl!l,LMnllltf PIF tlJZ IM1'lleodlletolletltt nl'IMtt.ce ~11

~ people'• espectatlou. These expectatlou are rormed from

aperlenc:e aad. by watching other penona,

fte -lal leanlln« theory approach t.o pel'KUl&Hty

Ibo.- directly on a penoo'• beharior (what did he do?) and
~ on hJa mottna. A relatively endmillg quality or
o!aanct.erlatlc la called a trcdt. I1111tead of trait., Walker
Nkabel (1993) dealt with cognitive ftliablea like:

a. com.petenciN which refer to varloua aJdl1a like

latellectual aMlltlea, aoclal and phyaical •Jdlla and other
1pecfaJ abWtlee
b. enoodln1 etrate&lff and peno-1 coutnlota-
-,,.rten«a that are retatned and categoriad "11 Uw
flldfofdual
Bllulple: Being asked to sing in a big gathering may be perceived
by • person as a welcomed opportunity to show off hie talent in
einging but may be seen by another as a threat torus or her ego.
e, aubjectl'ff vaJ:aea - what a person ccnelders as worth
11.a"rinC or accompllahlnC
,...mple: A student may perform lnpatlatln« tactics 1ill:e
stvta,c rood to the teacher jl'lllt ao he or aho oan pus tha

....
eoun~ All.other atudent mG¥ also do the same but his/her
purpose is for the teacher to make him or her number one ba
cl. eelf-replatin1 1:,wtema or plan• people have dlffeNnt
atandardl and ralea for replatln« their behavior (like Mlf·
bnpoffd rewarda for aacce .. ftd behavior or J>1Ud-hmeat for
faUIIJQ) including their plan• for reaohlnc his or her aoa]a.

IV. BU1UJII8TJC THEORY or LEARll1l'f0

People are seen rational {logical, reasonable, sensible],

am11•• and an motivated by eacb peraon'• needl, Mlf·
perception or 1elf-ooncept and the dealre to grow p01itlvely.
• llaalow'a theory of mottvation wilt.ch is based on the
hierarchy of need.a expJaln• why a hu.n,p:y patient will oot
pay attentloa to health "'chlnp utll hla/her phyalolopo
need of ha.oaer ta flnt met- beCote meetln« hie/her need for
lnfonnatfon or illauuction.
• B•maoS•tl.o theori.lta contend that poative aelf- -pt
and.1iilr-ateem euancea the learner'• uth••••- w Jeana
89
 a.e; 4APR'l!:5IAl.ndll!c l'tltw \Ix ... n, r1M to 8-ltllaue ·Prectloe 3011

and the teacher's role ill more of a fitcllitator of Jeamma rather

than an authority on teaching.

V. PSYCRODYIIAMlC'11fBORYOJ' L£ARiml'O

• This is more of a tMory of mattvation atre.eing emotfou

rather than eopltlou and reepoaeea and empbaalsee the
importance of conscloue or WlCOt1acl01U1 foroe1 111 guidltl&
behavior, penonallty eo11Jlicteat1d tlle enduring effects of
childhood experiences.
• BeheTior may be coll8dowa or Ulleon.sclou--- individuals
may or be aware of their motivations and why they think, feel
and act as they do.
• ~e id ts the most primitive ,o~e of motivation at1d ..
hued 011. Ubidln.111 energy.

The id is composed of the bade tnatfncta, impulae• and deal.Nia

we are born with and are composed of:
a. eroa (or Uf• foreej- the de1ire for pleaallNI and au
b. thaaatoa (or death wt&hl - theee are ag:reulve and
de.truellire impulses
• Tbe id operate• on the baala of the p1'ta8Un principle - to
aeek pleaaun and'"'°"' pa.In".
Implication, to teaclwlg-leanwaa process:

The patient or client will neither listen to or heed the

advice of the health educator whose methods are bori:n«,
1111enthuaiaatic and "not entertaining" la contrut to a
teaching-learning session where there la active partfc:lpaUon of
the leamer and he/she is ma.de to feel 111-charre of the
altu.atlon and is au important player in the teaching-learning
process.

90
 Leanwag styles an _,.. Ill which an Individual
proc:e- Information or dltferent approaches or methods of
learnlag.
• The habitual mllllller ID which Jearaera receive and
pe1eelve ID.formation, proceaa lt, uadentand it, '911Jue It,
store It, and recall It fde Yolllll, 2003).
• It involves affective, peychomotor and cognitive atylea

BeneOta of knowing the ~ styles of students:

1. The teacher can IDtervene once the learner experiences
difficulty by adapting techniques or atratea that are suited to
the student'• leamine style.
2. Enhancement of etrective teaming by improvtac Oil the
teachlae etrateglee and the inatnu:Uonal matertala that are
ued.

BASIC CO!fCEPTS OF COGIOTIVE STYLE

1. BoU.tlc va. analytic thillldng-

• 1-t~tstk (gLo~L) u,t~rs - look at the global or big picture
immediately & are interested in the ",t.t" of thillp,
the eneDee, or the eeneral Idea
• They look at the broad categories first before going into
details; they think deductively.
• A....aL!jtLe tht....iws - thJDk lopeally &11d objectively,
loolr:lnc at the details Ont.
:i. Verbal n. vieual representation
• People with verbal approach represent 111 their minds
what they read, aee or hear u ID term• of words or
verbal uaociationa.
• People with ~ approach experience In their m.uada
what the~d, ace or bear u mental plctmea or
hn..,...;:--
Nobody is a purely holistic thinker or a totally verbal or visual
learner but they weave or blend together as shown in the following
models.

91
 LEARl'fDfG 8TYLB IIODltt.S

Two of the moat commonly ued leamfng style modeJ.

that are frequently UJ1ed bl l'fma1D1a.re David Kolb'• Cycle of
Leamlq (1984) and Anthony Grecorc's Cognitive Styles
model (1982).

r-\ I. K~oclel, IWIO DOWD as the Cycle of Leaming,

b~s that the learner is not a blaDJtelate unlike the theory of
tabula rasa by John Locke but that the learner already bas
preconceived or predetermined ideas. According to Kolb,
1earnmg is a cont:IDuoua p1ocess which la a cumulative
re!lult of previous or past experiences, heredity and
interaction with the envil'oDment.

Impact of Kolb'• learning style on the educator:

Knowing the learner's preferred learning style will enable

the teacher to assist flu: learner ln modi.fgfng, refining or
even changing these preconcrir,ed ideas so that' real or better
learning can occur.

Kolb'a Theory of Elq)erlential learning- depicts a 4-stage

cycle or four modes of leanung which reneet two major
dimensions or perception or awareness of stimuli and
processing or dealing with the inf0177U1tit)n.

Kolb describea each learniJl.g style aa a combination of four

basic learning modes which are:

1. Concrete experience (CE) abilities : Leaming from actual

experience
2. ReOective obserntion (RO) abilities: Leaming by observiu.g
others
3. Abatraet conceptJ•alization (AC) abilities: Creating theories to
explain what le seen
4. Active experimentation (AE) abilities: Using theories to solve
problems.

92
 Kolb identified four lecrmlng styles and their
corre•poDdiu& c:hancterlatk:IJ where one atgk type wlll be
predominantlymanifested by the learner.

1 Con.verger: learns by AC and AE: good at declsion-mall:lna,

problem-.olvlug and prefers dealing with technical work
than interpersonal relationships; uses deductive reasoning to
solve problems; uses facts and data and has skills for
technology and specialist careers.
Leam.lo.& Methods: learns best through demoutratlon-
retum demonstration methods assisted by handouta,
dlagrams, charts, Wv.stratlona
2. Diverger: stresses CE and RO: people and feeling-oriented
and likes to work in poups;
Learning Methods: learns best through goup ducunlon•
and braiDstonnmg seaaions;· considers different
perspectives and points of view when looking at a concrete
situation or experience.
3. Accommodator. relies heavily on CE and AE: Impatient
with other people; a risk-taker, often using trial-and error
methods of solving problems; acts more on intuition, Instinct
or gut feelings rather than on logic; an achiever;
Learning Methods: eajoya role-pla:,lng, gamine and
computer aimulationa
• These learners are the most cballenglng to educators
because they learn best through new and exciting
learning experiences and are not afraid of taking risks
which may sometimes endanger their safety.
4. Arlldmilator. emphasizes AC and RO: more concerned with
abstract ideas than people; very good in inductive reasoning,
creating theoretical models, and integrating ideas and actively
applyingthem; uses logical thinking.
Learninl Methods: They learn best through lectures, one-to-
one instruction, and sel1'-lnstruction methods with ample
reading materials.

93
 Concrete Experience (CE)
"Feeling"
- - -
ACC.OMOnATOil
DIVERGER

Active Reflective
E,q>erimentatio11 Observation
(AE) (RO)
"Doing" "Watching"
CONVERGER ASSIMUATOR

Abstract Conceptualization (AC)

"Tbinlcing"

• Fig.9 K.olb'a Leuning Styles

Kolb's Leandng Style lnvent:ory (1984} is now a 12-item

tool with sentence completion items, The predominant score
based on the ranking process indicates the learner's style
(diverger, assimilator, converger, or accommodator). This has been
most frequently used in measuring the learning 11tyle11 of
1'anfng student. (DeC<)ux, 1990). It is based on Piaget's and
Guilford's theories of thinking, creativity, and intellect

DIPUCA'ffONS:

~ u1Dc cU&nnt teacbblg atrategloa that are awted to then

four 1eanung styles, a match or ftt CUI be created by the
teacher ill relation to the methods of teach.in~ that will be
-d where, for -ry group of learners, 25% will fall into each of
the four categories. uami ollly one method, like tbe Jeeture
method, 'lriJl aelecttvely ezdude 75% of an the leamera ill
that putlcular claas.
When teacbJng groups of learners, hl.atructlon abould begin
with activtttM suited to the •••
1, d.ive:rgent thinker (group dJacuuiona and
bram.tonnJ.ng NUions);

94
 2. and progreaa aequent!aJly to activitl•• for
aaalmilato_! {lectures, oae-to-one illatructlon, and
self-lnatructlon methods with ample reading
materials); .
3. converger (demonstration- return demonstratloi
methods assisted by hand.onta, diapma, charts,
muatratlona);
4. and accommodator (eajoya role-playing, gaming and
computer 11lmolationat ln that order (Amt &
Underwood, 1990).

Bued on the abovementioned, what llcilld of a thinlrer are

,ou? What learning style (a) will beat ault your need,?

II. Gregorc Cognitive Style, Model

Orcgoro has identified four aeta of dnalltle, (aituatlona

that consist of two parts that arc complementary or op~d
to each othert. The mind ha, the mediation abWtlea of:

1. perception - the way one receive• or papa lncomln&

Information or atimulua in a continuum ral1&iDg from.
abatractneaa to concretene89.
2. orderinc of knowledge -·the way one arrane•• and
1ystematlse1 incoming stimuli in a continuum or scale ranging
from sequence to randomneas which alfecta the way a penon
learns.
According to Gregorc, everyone procene1 or deall with
perception and ordering of knowledge in all four dimeuiona
but ma,y have preferences or choices of doing it which may fall
into 4 mediation channels, namely:
1. Concrete sequential (CS)- learners like bi&b,ly structured,
quiet leaming envirollmentl without lnterruptlona; like
concrete learning materials especially visual• and gives focus
on details; may interpret worde llterally.
2. Concrete random (CR) -intuitive, trial-and-error method
of 1.-rning, looks for alternatives
3. Abat.ract aeq\lential (AS) · learners are hollatic thinkers
and need conaiatency in the loaming environment; do not like
lnterruptJona; have good verbal aldlla, are rational and lopcal.

95
 4. Abetract random !ARI· think hoUaticaily, learn a lot from
visual stimuli; pnfer bQJ', -.trv.ctured leamma
environmenta;" focused on penonal relatlollahips.

Gregorc developed the Qregorc Style Dellneator, a self·

report inventory where the rcabject chooea the word that beet
deacribes him or her. The leam1Dg atylea are scored and the
highest number or total acorea indlcatea the preferred
learnln& style.
JD. GARDJ!IF.R'S SEVE1' (7) TYPlt8 OF llffELLIGENCB
(A t1wory ~ to clttldren'• i.arntng atg1es)

The fMOrJI of multiple tnt.Ufgcnc:e (Gardner) states that

there are varioua type• of talent or -n forma or intetuaence
which may all be ftilly developed in a lifted child but on the
avera,e, about three to four types may be possessed or
developed by an individual or child. All leamen have all the
seven kinda or illteUJceu.ce but in different proportions
(Bastable, 2003). Another facet of intelligence is termed as
N~lst which refers to flora and fauna, has a green thumb,
enjoys pets, enjoys nature, classifies species, discriminates among

below·
Typotof
loltfi&tJICt
Oo••••of
lottn,...,e & "'"
of the bral•
-~
plants and animals, concern for environment. These are presented
-ofiat•IIJSeaoe
(ffflurt1, Olpe<la or
cbor1cttrbtlc, or

- ..
lolcll'-n..,I
I, vc:l'Nl/
li111•J•rk
11 .. d ....
-111,,c
wrldoe,

·fond la t,n,a', •ra

......
Dab ,ritli w-rfttt• ••d

'""--=
wordt or
Uadcne:.ndln,: die unler Ii
mra•i•tlwonl11;
In left ,ide: albrai• lk-•od .....
efllop"l<(t);
coavhd11&
kboltl upl1loltlg In WONts.
tttdo1; tdll .. or a,Joylq
""""''
,·erhlll Joke.; cn1tivc: writiq &

·----
1---'-do• of--+-
2. 1oc1.. v Cal<......... ,,_. Rdtntof..d:wtheA htkro ,....m11o., •Idle
M•tt11ea1tic::tl '°"col dedll<lh'• .....-.., prdklions. atm•tina,
M>lvl>c,
,.....iq,.
ttatiJda.
ualy1ls.

_, ....... -.w..or
_.,.... -'• t.d•d:fve & dtdvctlYt
RUODi.q:~dileendPI
Nlatlo....... .,. ............
thf Rni1 ....- ptrformhe .... pit,
cakutatiom,admtft~
.......... " ptrlom,1
aperl-U.mldq
••plulllon1,cottpri.d•
....
lef<>nMdocl, romp•ter

J'tg, 10 Gud.D«'a TlleOJY of KaltfpJe ID.teJ.lfCence

96
 Artl, e...ttt, ma~ r-.,-cl•ca the abi&ty tu Rttwpu.iac. n:latioo1ldpe ut
8")11<1ry, dalp. fflU.aUu •• ~bjed or to objttta ia 1p1ct+titntc of
• rtgllt- of broln CIUR: 1...- or dirttdoa, fl-'-1: 19Ur ••Y
.,..... 1 1...,..; abill!J al'01lad, dnrwing, s-fati:llig,
lO trudorm. Gr ff- xalpllq; ..ior dlltrlmlllllloa,
tor.i.c \'!sow .,. .. pttti,•e 1alcl.,.;'.. a ..
..
crttt.e ltiget;
&. rocati,a mtQUl I '*'O]lado•
,- iti..tty
i;. .. to rt.)'th .. U-ng SlnltlVt of
Apprc<ialio.. -~
iDlfNIIIMfttll, ••d hta.t, rcaipitiow nl muit, c:n:1tiog ' tnelc:MIMtJ
«>mposldoa ud ton.al patterns & pitdt, rbytat, 1totl,c q .. 1111« of •
la and ap]lrt<hldoo et coee, playing .,. tuerum,eot,
rby1!UL• loltDd
·Ji&.rildt<If brala mmltal expt'USioo; n:pealag • tuoe, .--i.;,.
Atblttitt. dU<'t. Ta tug 111 11•d
«>•---
Haad.eyt ,::oordiaatim, mi.wfit
acti•~ manual proet::1Stai:: of (laduttng tr l01p<.-affog)
demf'ity,-tYtrt'i~ knnwl~e tbroUf:htkc •billtlts, lj/tN, •&Jiii)' ,.
·bual pi,glia & u~ cir tkMtily strt-.ctl; t11d111tUtt, ·worldag
ecrcbdlu, & olber st»&a.tltJ.1t; lffnih•g if with toob, attd. rot' «>ash.at
ttrurhlrc:, aocvmplit.b.td 1hrougb "'O''tl'll.eot c,r ntn:i_te
.... - "' body
IJnauaJtC or phyMtal
WIOV(;nl(ftt:
6.. iDtttpc,no~I C'.omn1:11•lty servict; F... p111$i$ n• Vcrhal/nmi-,·crbal
1.a.kJllg.rocc rolt..~·lne, coaJlk,1 tom.1111ntcation 111d ,::omn1.a11ics.tio11'-.dit.Crminc
rt:t0lutioo1 i11.f~rpcc.so.lW 1t11dftiyiq in:~•tin.tis.. behavior
lude.nhlp, rel1t~OR$hip, & l)tnt)Ct'Ci\'t6. t.illpa1'.)".
ttAmwork. ,rorl<llg _.,.dvely,
-pn:froolal lob<s •cmilivity to oO.tt'a JDOOdl.
motivts aad ttclings. lttdlag
others. makia1t & "4,:piar.
Mendo
7. !ntrapmoaal Jour811iflll, penonal Rthirttd te ln»cr Atc\lrart Kif.perception. ~tr.
llltllrc-< ··~Ut.b, thoUJ:ht p1'0Cd.1d &'11tb teflttdVf+Sf!lf·dirtttecf, $Niie of
reflecdoa., •f . rc.OttlJOl IIDd valotS, lnMdve, lod,<pencka~
Kt:d.Jtg. mctacognltio•; IWU"fOtS$ 111ud tJprmktn of
rtports ladudts spirit-.al r«tinp.
-prctroatal ktba awa:ttots!lffldopmt11t
and w:lf-bow1....i.::e.

Gardner's Theo.ry of Multiple Intelligence

97

.-
 SUMMARY

Thia chapter dealt with the toola or trade that an

educator muat poaaeA umely the theorlea and prbu:iples or
teachlu.l and leana1D1. KDowiaC the learoilll aeeda of the
atudent aa well aa their 1eamJ.al 8tylea la of primary
importaace la th• planning, taplementatloa and evaluation of
the health education pro&raJD8. To make learaiDf iatereatln.1
aad eajoyable, the educator mu.st lmow the appropriate
atrat•IJ•• and methoda of tuchial aad be able to create wbat
ta called the "teachable" moment when the learner la ready to
leal'll.

Thia will aerve aa the ll&hthouae that wW guide the

educator ID the journey towarda the attalament of healthy
communltiea throQP healthy Uleatylea. The myriad form• of
problem• that coa&ont the aocfety today are moaUy a reeult
of Uleatyiee and valuea related to health promotion aad
mainteaaace which can be traced to the broader aocietal
envlroament.

The challen1e la peat but llmowia1 the leunen'

characteriatica, their lea&'llinlneede aad leani1D1 etylee aad
what theories to apply will "make the impoAible poulble".

.....
"Yooafor 71iouelit"
~ .
"£a'Uf}Fiter is the Gest medicine" ... so Iet's CaUfJFi a.wfiik.
'I1iere are two i.iru£s of"pedestrians-
tli.e quici and' tli.e aeaa. .....
'Before marriage; a man yearns for the woman lie ioves.
.:4fter marriage, tli.e y liecames stiens.

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