Chapter 4

DETERMINANTS OF LEARNING

OBJECTIVES:

After the completion of the chapter, the students will be able to:
1. assess the learning needs;
2. determine the readiness to learn; and
3. classify the learning styles.

PRETEST: Let us see if you know something about out topic for today since
assignment was given previously. Write your answer on the space provided that
corresponds to the description.
______________ 1. The test given to the student to assess or diagnose the needs of
the learner before the start of the new lesson
______________ 2. The basic need of the learner before any other things
______________ 3. The feeling that greatly contributes to the anxiety and negative
readiness to learn
______________ 4. The orientation or point of view of the learner which is receptive to
any innovation
______________ 5. The learning by just watching, listening to or reading about what
the other people is doing rather than doing it by himself/herself

A. Assessment of Learning Needs

Haggard (1989) – “educator’s role in learning is primarily to assess the learner in relation
to 3 factors that affect learning or what is termed as determinants of learning:
1. Learning needs
2. Learning readiness
3. Learning style
I. Learning needs – gaps in knowledge that exist between desired level of
performance and the actual level of performance (Healthcare Education Ass’n,
1985); the gap or differences between what someone knows and what someone
needs to know due to lack of knowledge, attitudes or skills.
Some Methods Used in Assessing Learning Needs (Bastable, 2003):
1. Informal Conversations or interview - w/ the patient or family members or
friends by asking open-ended questions
- Anecdotal records -
2. Structured interview – predetermined questions to gather information
regarding learning needs in w/c answers may reveal uncertainties, anxieties,
fear, unexpected problems and present knowledge base.
Ex: a. What do you think caused your problem?
b. What does your illness/health mean to you/
c. What are your strengths and weaknesses?
3. Written pretests – diagnostic; compare to a post-test
4. Observation – health behaviors over a period of different times may help
determine established patterns of behavior; Ex. Are all the steps performed correctly?
Teacher’s ultimate gauge of success: - to be able to transfer one’s skills,
knowledge, values, and attitudes to the learners:
 How to Achieve? – provide, arrange or manipulate experiences and situations in
the environment so that the learner can have a better understanding, acquisition and
application of the learning experience for intelligent and productive living.
As health provider, learners may be the students in the classroom, clinical, or
hospital areas and the community, the patient or patient’s family; Teaching will always
be an integral (essential) part of the health provider’s profession
Milieu – group of people or activities that you live among are familiar
- Assessing the needs will mean ready to design teaching plan.
- Learning is a relatively permanent change in mental processing, emotional
functioning and/or behavior as a result of experience.

Steps in the Assessment of Learning Needs:

1. Identify the learner
2. Choose the right setting – a trusting environment by ensuring privacy and
confidentiality
3. Collect data on the learner
4. Include the learner as a source of info
5. Include members of the healthcare team – collaborate with the other healthcare
professionals who may have the insights or knowledge of the patient or the
learner
6. Determine availability of educational resources – appropriate, available,
affordable, easy and simple to manipulate by the learner
7. Assess demands of the organization – the organizational climate, its philosophy,
vision, mission, and goals to know what is its educational focus. Ex. health
promotion and disease prevention rather than rehabilitative care
8. Consider time -management issues – allow learners to identify their needs;
identify potential opportunities to assess the patient anytime, anywhere; and
minimize distractions/interruptions during planned assessment interviews
9. Prioritize needs – based on Maslow’s hierarchy of needs where the basic lower
level physiologic needs must first be met before one can move up to the higher ,
more abstract level of needs; steps go up from the lowest to the highest rung on
the top of the ladder:
Top – self-actualization – recognition and realization of one’s potential,
growth, health, autonomy
Self-esteem – sense of self-worth, self-respect, independence, dignity,
privacy, self- reliance
Love and belongingness needs – affiliation, affection, intimacy, support,
reassurance
Safety and security needs – safety from physiologic and psychological
threats, protection, stability
Base - Physiological Needs: Oxygen, Food, elimination, temperature
control, sex, movement, rest, comfort

Figure 4.1 Maslow’s hierarchy of needs

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Criteria for prioritizing Learning Needs (Healthcare Educ Ass’n, 1985):

1. Mandatory – learning needs that must be immediately met since they are
life threatening or are needed for survival. Ex. patient with history of recent
heart attack
 2. Desirable – learning needs that promote well-being and are NOT life-
dependent. EX. Patient w/ PTB needs to understand and appreciate the
importance of taking medicines regularly
3. Possible – “nice to know” , learning needs NOT directly related to daily
activities

II. Readiness to Learn – willing to learn or receptive to information

            How to assess readiness to learn:
1. Determine what needs to be taught
2. Find out exactly when the learner is ready to learn
3. Discover what the patient wants to learn
4. Identify what is required of the learner
5. Determine if timing is right or proper
6. Find out if rapport w/ the learner has been established
7. Determine if the learner is showing signs of motivation
8. Assess if teaching matches the developmental level of the learner

B. 4 Types of Readiness to Learn (PEEK) (Lichtenthal, 1990):

1. Physical Readiness
a. Measures of ability – requires visual and auditory acuity (sharpness of
vision and hearing); patient’s hearing and sight are impaired
b. Complexity of task – difficulty level to be mastered
c. Environmental effects – if conducive to learning
d. Health status
e. Gender – men are less inclined to seek health consultation or intervention
than women
2. Emotional Readiness
a. Anxiety level – fear greatly contributes to anxiety and exerts negative
effects on readiness to learn whether it be on the cognitive, psychomotor
or affective
b. Support system – from immediate family and friends, and significant
others, community and church if weak or absent elicits sense of insecurity,
despair, frustration and a high level of anxiety
Health provider’s emotional support to the patient and family
members is called “reachable moments” w/c allow opportunity
for the health provider and client to mutually share and discuss
concerns and possible solutions or alternatives to care.
c. Motivation – when the learner starts asking questions and showing interest
in what the teacher is doing or saying
d. Risk-taking behavior – activities w/o much thought to what their negative
consequences. Health educator must develop awareness in the patient as
to how this can shorten his lifespan; how to develop strategies to minimize
the risk; to recognize the signs and symptoms of probable disease state
and what to do should this worst-case scenario develop
e. Frame of mind – depend on the priorities of the learner
f. Developmental stage – determines the peak time for readiness to learn or
“teachable moment”
3. Experiential Readiness – previous learning experiences, positive or negative
a. Level of aspiration – depends on the short-term or long-term goals that the
learner has set
 b. Past coping mechanism – how the learner was able to cope with or handle
previous problems or situations and how effective were the strategies used
c. Cultural background – to assess and know from the patient’s own cultural
perspective (prime importance);
- Find out also if the patient understands the language used to
communicate with him
d. Locus of control – motivation to learn may be:
d.1 – internal locus of control or intrinsic – w/in the individual as he/she is
driven by the desire to know and learn;
d.2 – external locus of control or extrinsic – influenced by others to learn
(inspiration . . .)
e. Orientation – person’s point of view:
e.1 – Parochial – close minded thinking, conservative in their approach to
new situation less willing to learn new materials and have a great trust in the physician
e.2 – Cosmopolitan orientation – a more worldly perspective and more
receptive to new or innovative ideas like current trends and perspective in health
education

4. Knowledge Readiness – refers to:

a. Present knowledge base – stock knowledge or how much one already
knows about the subject matter from previous actual or vicarious learning
vicarious – experienced by watching, listening to, or reading about
other people doing something rather than doing it yourself
b. Cognitive ability – involves lower level of learning w/c includes memorizing,
recalling or recognizing concepts and ideas and the extent to w/c the info
is processed
The teacher MUST recognize cognitive impairment due to mental
retardation
Learning disabilities – and low-level reading skills will need special
approaches to teaching to prevent discouragement and bolster (increase)
readiness to learn

C. Learning Styles

III. Learning Styles – indicates how people learn in uniquely different ways:
1. Global (holistic) thinkers and some are analytic
a. Holistic thinkers – look at the global or big picture immediately; interested
in the gist of things, the essence, or the general idea; look at the broad
categories first before going to the details; think deductively
b. Analytic thinkers – think logically and objectively; looking at the details
first
2. Auditory sources than from visual stimuli
a. Verbal or auditory approach represent in their minds what they read, see
or hear in terms of words or verbal association
b. People with visual approach experience in their minds what they read,
see or hear as mental pictures or images
3. Some Learn better when in group than independently or alone

Nobody is purely holistic thinker or a totally verbal or visual learner but blend
together
 Learning styles are used interchangeably with cognitive styles. Learning
styles are defined:
1. Ways in w/c an individual processes information or different approaches or
methods of learning,
2. Habitual manner in which learners receive and perceive information, process
it, understand it, value it, store it, and recall it (de Young, 2003)
3. Involves affective, psychomotor and cognitive styles

Importance of Knowing the learning styles of students:

1. The teacher can intervene once the learner experiences difficulty by adapting
techniques or strategy that are suited to the student’s learning style
2. Enhancement of effective learning by improving on the teaching strategies
and the Instructional Materials used

Learning Style Models: (used in health Care):

1. David Kolb’s Cycle of Learning – believes that the learner is NOT blank
slate, it has a preconceived or predetermined ideas.
          According to Kolb, Learning is a continuous process which is a
cumulative result of previous and past experiences, heredity and interaction
with the environment.
- Impact of Kolb’s learning style on educator: knowing the learner’s
preferred learning style - - enable the teacher to assist the learner in
modifying, refining or changing the preconceived ideas so that real or
better learning can occur.

2. Anthony Gregorc’s Cognitive Style Model - identified 4 sets of dualities;

situations that consist of 2 parts that are complementary or opposed to each
other. The mind has the mediation abilities of perception and ordering of
knowledge which affect how a person learns.

3. Kolb’s Theory of Experiential Learning – depicts a 4-stage cycle or 4

modes of Learning:
1. Concrete Experience (CE) abilities – learning from actual experience;
“feeling”
2. Reflective observation (RO) abilities – learning by observing others;
“watching”
3. Abstract Conceptualization (AC) abilities – creating theories to explain
what is seen; “thinking”
4. Active experimentation (AE) abilities – using theories to solve problems;
“Doing”

Four learning styles according to Kolb’s Theory:

1. Converger –
a. learns by AC and AE;
b. good at decision making, problem-solving; and
c. prefers dealing with technical work than interpersonal relationship;
d. uses deductive reasoning to solve problems;
e. uses facts and data and has skills for technology and specialist careers
 Learning Methods – learns best through demonstration – return
demonstration, methods assisted by handouts, diagrams, charts, illustration
2. Diverger - divergent thinkers
a. stresses CE and RO;
b. feeling oriented and likes to work in groups;
Learning Methods – learns best through group discussions and
brainstorming sessions; considers different perspectives and points of view
when looking at concrete situation or experience
3. Accomodator –
a. relies heavily on CE and AE;
b. impatient with other people;
c. risk taker, often using trial and error methods to solve problems;
d. acts more on intuition, instinct or gut feelings rather than on logic;
e. an achiever
Learning Methods – enjoys role-playing, gaming, computer simulations;
most challenging learners to educators because they learn best through new
and exciting learning experiences, not afraid to take the risks that may
endanger safety
4. Assimilator – assimilate – adopt or learn
a. Emphasizes AC and RO;
b. More concerned with abstract ideas than people;
c. Very good in inductive reasoning;
d. Creating theoretical models;
e. And integrating ideas actively applying them;
f. Uses logical thinking
Learning Methods – learn best through lectures, one-to-one instruction, self-
instruction methods with ample reading materials

4.Gregorc Cognitive Styles Model stated that mind has the mediation abilities:
1. Perception ability – receives or grasps incoming info or stimulus in a
continuum ranging from abstractness to concreteness
2. Ordering ability – the way one arranges and systematizes incoming stimuli
in a continuum or scale ranging from sequence to randomness

4 mediation channels:
1. Concrete sequential (CS) – learners like highly structured, quiet learning
environments without interruptions;
- Like concrete learning materials especially visuals and give focus on
details;
- May interpret words literally
2. Concrete random (CR) – intuitive ;
- Trial-and-error method of learning;
- Looks for alternatives
3. Abstract sequential (AS) – learners are holistic thinkers and need
consistency in the learning environment;
- Do NOT like interruptions;
- Have good verbal skills;
- Rational and logical
4. Abstract random (AR) – think holistically;
- Learn a lot from visual stimuli;
 - Prefer busy, unstructured learning environments;
- Focused on a personal relationship

D. Principles of Learning that Motivate the Learners

Principles of learning that can motivate the learners: (de Young, 2003)
1. Use several Senses: retention of what has been learned –
a. Reading – 10%
b. Hearing – 20%
c. See or watch – 30%
d. See and hear – 50%
e. Say – 70%
f. Say and do – 90%
- This is the importance of laboratory where students imitate the procedures
that are demonstrated by the instructors (role-modeling; return demo)
-are graded according to skills they exhibit and the degree of comprehension
of the rationale behind the procedures
2. Actively involve clients in the learning process – use more interactive
methods involving the participation of the learners like role-playing, buzz
sessions, Q & A (question and answer) format, case studies, small group
discussion, demonstration, and return demo
3. Provide an Environment conducive to Learning – always consider comfort
and convenience of the learner: room temp; chairs, and seating arrangement
or space, noise level, adequate acoustics and sound system, clean, pleasant-
smelling and smoke and dust-free
4. Assess Learning Readiness – readiness to learn is affected by factors like
emotional status ( anxiety, fear, depression) and physical conditions (pain,
visual, or auditory impairment, anesthesia, etc)
5. Determine the relevance of info – anything perceived by the learner to be
important or useful will be easier to learn and retain.
6. Repeat the Info – continuous repetition of info over a period of time
enhances learning; applying the info to a different situation, then to another
situation or rewording it and giving practical applications
7. Generalize Info -
8. Make learning a pleasant experience – give frequent encouragement,
recognize accomplishments and give positive feedback
9. Be systematic – begin with what is known; move toward the unknown
10. Be steady – present info at an appropriate rate

ASSSIGNMENT:

1. Discuss the theories and laws of learning;

2. Determine the types of learning and learning styles;
3.Give the characteristics of the principal concepts of behavioral, cognitive and social
learning theories.
4. Classify the Taxonomy of Educational Objectives

ANSWERS TO PRETEST:
1. Pretest
2. Physiologic needs
3. Fear
 4. Cosmopolitan
5. Vicarious

POSTTEST: Let us check if you can answer the following correctly. Write the answer
that corresponds to the description on the space provided.
_______________ 1. The thinkers interested in the summary or general idea rather
than the details
_______________ 2. The thinkers looking at the details first
_______________ 3. From the Kolb’s Theory of Experiential Learning, this refers to the
ability which is learning from feeling or actual experience
_______________ 4. From the Kolb’s Theory of Experiential Learning, this refers to the
ability which is learning by doing or using theories to solve problems
_______________ 5. The mediation ability by arranging systematically the incoming
stimuli in a scale from sequence to randomness

REFERENCES:

Acero-De Ocampo,Victorina C.,Javier-Sanchez, E., and Castro-Ocampo,H.(2017).  

Principles of teaching I. Revised Ed. Rex Bookstore, Philippines.

Castro-Estrada, Cecilla. (2009). Teaching strategies in health education with

principles of teaching and learning. First Ed.Educational Publishing
House, Inc. Ermita, Manila.

https://www.simplypsychology.org/maslow-needs2.webp