1.

Learning
Learning
 Is a change in human disposition or capability that persists over a period of time
& that can’t be solely accounted for by growth.
 Acquiring new knowledge, behavior, skills, values, preference or understanding
and may involve synthesizing different types of information
3 TYPES OF LEARNING STYLES:
1. Visual -  individuals learn by seeing the material in a book or behaviors that are
shown to them
2. Auditory -  learners learn best by hearing the concept explained to them.
3. Kinesthetic -    learners need to touch and do thing with their hands.  They learn
best by doing something tactile to learn the concept.
Learner Characteristics:
These are many factors that influence a clients ability, motivation and desire to learn
1. Culture
 Defined as invisible patterns that form the normal way of acting, feeling,
judging, perceiving and organizing the world.
2. Literacy
 The client’s ability to read and understand what is being read is an
essential component of learning.
3. Educational level and health status
4. Age
5. Socioeconomic level

Learning Principles
 Provide an environment conducive to learning
 Actively involved in the patient’s/clients in the learning process
 Make learning a pleasant experience
 Assess the extent to which the learner is ready to learn
 Present information at an appropriate rate
 Determine the perceived relevance of the information’s
 Repeat information
 Use several senses
 Generalize information

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Factors affecting learning
 Feedback
 Active involvement
 Readiness
 Relevance
 Motivation
 Physiologic events
 Emotions
 Repetitions
 Culture aspects
 Environment
 Non-judgmental support
 Timing
 Simplex to complex

Types of Motivation:
1. Intrinsic Motivation
 Based on the fundamental needs and drives of the students which triggers
his/her innate desire to act? (Ex. Desire to acquire knowledge, to explore
or to construct)
 Student devoting of the effort to learn is what is being learned is
interesting, significant, meaningful and enjoyable.
2. Extrinsic Motivation
 Is external and is more/less based on the incentives to make students
more active and responsive and the effect of such incentives varies in
relation to gender, age and mental ability.

Techniques in Motivating Students:

 Grouping  Self-paced, programmed
 Games and simulation test
 Volunteering  Emphasizing reward not
 Offering to help punishment
 Knowledge to result  Grades and test
 Contracts  Using praise and
 Accepting diversity encouragement
 Use of audio-visual aids  Providing exploration

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OBSTACLES TO LEARNING
1. Lack of time to learn due to rapid patient discharge from care can discourage and
frustrate the learner, impending the ability and willingness to learn.
2. The stress of acute and chronic illness, anxiety, sensory deficits, and low literacy
in patients are just few problems that can diminish learner motivation and
interfere with the process of learning.
3. Low literacy and functional health illiteracy in patients
4. The negative influence of the hospital environment itself, resulting in loss of
control, lack of privacy and social isolation.
5. Readiness to learn motivation and compliance - personal characteristics of the
learner have major effects on the degree of learning
6. The extent of behavioral changes needed, both in number and complexity.
7. Lack of support and ongoing positive reinforcement from the nurse and
significant others.
8. Denial of learning needs, resentment of authority and lack of willingness to take
responsibility.
9. The inconvenience, complexity, inaccessibility, fragmentation and
dehumanization of the healthcare system.

 Compliance- individual’s desire to learn & to act on the learning

 Andragogy- the art & science of helping adults
 Pedagogy- the discipline concerned with helping children to learn.

Domains of Learning:
TAXONOMY - listing of the hierarchy of objectives within a domain
1. Cognitive Domain – thinking domain
a. Knowledge – remembers previously learned material
b. Comprehension – understands/interprets the meaning of learned material
c. Application – applies newly learned material in a new concrete situation
d. Analysis – breaks learned material into component parts and separates
important from unimportant material
e. Synthesis – takes part of learned material & puts them together to form a
new  material
f. Evaluation – judges the value of the learned material
2. Affective Domain – attitudes, values, beliefs domain
a. Receiving – this level represents a willingness to selectively attend to or
focus on a data or to receive stimuli.

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 b. Responding – indicates a movement beyond denial towards voluntary
acceptance which can lead to a feeling of pleasure or enjoyment as a
result of some new experience
c. Valuing – means attaching worth to an object or behavior           
d. Organizing – to organize, classify & prioritize values by integrating a new
value into a general set of values
e. Characterization – involves acting & responding with a consistent value of
system. The person behaves consistently when values are tested
& challenged.
3. Psychomotor domain - physical skills
a. Perception - having stimuli coming in and affect your senses.
b. Set - know about them or given you cues to perform
c. Guided response - beginning performance
d. Mechanism-  performing simple tasks well
e. Complex Overt Response - acting out, skill performance of complex tasks 
f. Adaptation - modification of special problems
g. Origination - try new ways of doing things on your own; created new
patterns of doing things

Abraham Maslow developed a theory of personality that has influenced a number of

different fields, including education. Maslow is a humanistic psychologist.

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Self-actualization
 Morality  Problem solving
 Creativity  Lack of prejudice
 Spontaneity  Acceptance of facts
Esteem
 Self-esteem  Respect of others
 Confidence  Respect by others
 Achievement
Love/belonging
 Friendship  Sexual intimacy
 Family
Safety - security of:
 body  the family
 emplyment  health
 resources  property
 morality
Physiological
 breathing  sleep
 food  homeostasis
 water  excretion
 sex

Humanists do not believe that human beings are pushed and pulled by
mechanical forces, either of stimuli and reinforcements (behaviorism) or of unconscious
instinctual impulses (psychoanalysis). Humanists focus upon potentials. They believe
that humans strive for an upper level of capabilities. Humans seek the frontiers of
creativity, the highest reaches of consciousness and wisdom. This has been labelled
"fully functioning person", "healthy personality", or as Maslow calls this level, "self-
actualizing person."
Maslow has set up a hierarchic theory of needs. All of his basic needs are
instinctual, equivalent of instincts in animals. Humans start with a very weak disposition
that is then fashioned fully as the person grows. If the environment is right, people will
grow straight and beautiful, actualizing the potentials they have inherited. If the
environment is not "right" (and mostly it is not) they will not grow tall and straight and
beautiful.

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 Maslow has set up a hierarchy of five levels of basic needs. Beyond these needs,
higher levels of needs exist. These include needs for understanding, aesthetic
appreciation and purely spiritual needs. In the levels of the five basic needs, the person
does not feel the second need until the demands of the first have been satisfied, nor the
third until the second has been satisfied, and so on.
Maslow's basic needs are as follows:
Physiological Needs
These are biological needs. They consist of needs for oxygen, food, water, and a
relatively constant body temperature. They are the strongest needs because if a person
were deprived of all needs, the physiological ones would come first in the person's
search for satisfaction.
Safety Needs
When all physiological needs are satisfied and are no longer controlling thoughts and
behaviors, the needs for security can become active. Adults have little awareness of
their security needs except in times of emergency or periods of disorganization in the
social structure (such as widespread rioting). Children often display the signs of
insecurity and the need to be safe.
Needs of Love, Affection and Belongingness
When the needs for safety and for physiological well-being are satisfied, the next class
of needs for love, affection and belongingness can emerge. Maslow states that people
seek to overcome feelings of loneliness and alienation. This involves both giving and
receiving love, affection and the sense of belonging.
Needs for Esteem
When the first three classes of needs are satisfied, the needs for esteem can become
dominant. These involve needs for both self-esteem and for the esteem a person gets
from others. Humans have a need for a stable, firmly based, high level of self-respect,
and respect from others. When these needs are satisfied, the person feels self-
confident and valuable as a person in the world. When these needs are frustrated, the
person feels inferior, weak, helpless and worthless. 
Needs for Self-Actualization
When all of the foregoing needs are satisfied, then and only then are the needs for self-
actualization activated.
 Maslow describes self-actualization as a person's need to be and do that which the
person was "born to do."
 "A musician must make music, an artist must paint, and a poet must write." These
needs make themselves felt in signs of restlessness. The person feels on edge, tense,

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lacking something, in short, restless. If a person is hungry, unsafe, not loved or
accepted, or lacking self-esteem, it is very easy to know what the person is restless
about. It is not always clear what a person wants when there is a need for self-
actualization.
The hierarchic theory is often represented as a pyramid, with the larger, lower
levels representing the lower needs, and the upper point representing the need
for self-actualization Maslow believes that the only reason that people would not move
well in direction of self-actualization is because of hindrances placed in their way by
society. He states that education is one of these hindrances. He recommends ways
education can switch from its usual person-stunting tactics to person-growing
approaches.
 Maslow states that educators should respond to the potential an individual has
for growing into a self-actualizing person of his/her own kind.
Ten points that educators should address are listed:
1. We should teach people to be authentic, to be aware of their inner selves and to hear
their inner-feeling voices.
2. We should teach people to transcend their cultural conditioning and become world
citizens.
3. We should help people discover their vocation in life, their calling, fate or destiny.
This is especially focused on finding the right career and the right mate.
4. We should teach people that life is precious, that there is joy to be experienced in life,
and if people are open to seeing the good and joyous in all kinds of situations, it makes
life worth living.
5. We must accept the person as he or she is and help the person learn their inner
nature. From real knowledge of aptitudes and limitations we can know what to build
upon, what potentials are really there.
6. We must see that the person's basic needs are satisfied. This includes safety,
belongingness, and esteem needs.
7. We should refresh consciousness, teaching the person to appreciate beauty and the
other good things in nature and in living.
8. We should teach people that controls are good, and complete abandon is bad. It
takes control to improve the quality of life in all areas.
9. We should teach people to transcend the trifling problems and grapple with the
serious problems in life. These include the problems of injustice, of pain, suffering, and
death.

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10. We must teach people to be good choosers. They must be given practice in making
good choices.
 
STEPS IN THE LEARNING PROCESS
1. MOTIVATION – an organism is constantly being bombarded by a lot of stimulus
from his environment. 
2. GOAL – behavior being purposive, is oriented towards a goal. What will
determine whether or not a person will strive towards a goal is the perceived
probability of success.
3. READINESS- depends on training and experience as well as heredity.  It is typed
according to
 Physiological factors – maturation of sense organs
 Psychological factors – motives, emotional factors, self-concept
 Experiential factors – previously learned skills, concepts etc
4. OBSTACLE – its presence is occasion for learning new modes of adjustment.  It
may be social, nonsocial, personal and internal.
5. Responses – are varied according to one's interpretation of the situation.  The
need to solve a problem on the spot or manner of circumventing.
6. Reinforcement – responses are reinforced if they satisfy one's needs.  These
responses are liable to be repeated.
7. Generalization – the application of what one has learned.
KINDS OF LEARNING
 HABITUATION – a phenomenon whereby we get used to something
 ASSOCIATIVE LEARNING – forming new associations between a stimulus and
a response  (habit formation)
 SOCIAL LEARNING – involves observing an imitated model
 SKILL LEARNING – involves competency and proficiency in a certain kind of
performance.
 VERBAL LEARNING – involves the use of words either as a stimuli or responses
 COGNITIVE LEARNING – all activities that fall under higher mental processes
are involved
THEORIES OF LEARNING
 Connectionism  or the S-R (Stimulus-Response) Bond Theory – through
conditioning, specific resgrdiponses come to be linked with a specific stimuli
 Functionalism – states that behavior and mental processes are adaptive
 Gestalt Theory – making use of insight as a basic principle
 Sensory Stimulation Theory – effective learning occurs when the senses are
stimulated.

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 Holistic learning theory – the basic premise of this theory is that the individual's
personality consists of many elements that require activation if learning is to be
more effective.
 Behaviorism – learning is a process of building conditioned reflexes.

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2. Teaching
CONCEPTS OF TEACHING
—  *TEACHING implies a didactic information giving approach whereas PATIENT
EDUCATION implies something more comprehensive for which specialist skills are
required.
—  *Teaching requires special training in instructional skills if education programs
conducted by nurses are to be successful.
—  *And lastly, TEACHING is an essential component of nursing practice in caring for
both well and ill patients.
BARRIERS TO EDUCATION
1.  Lack of time to teach is cited by the nurse as the greatest barrier to being able to
carry out their educator role effectively.
2.  Many nurses and other healthcare personnel are traditionally ill prepared to teach.
3.  Personal characteristics of the nurse educator play an important role in determining
the outcome of a teaching-learning interaction.
4.  Low priority was often assigned to patient and staff education by administration and
supervisory personnel.
5.  The lack of space and privacy in the various environmental settings where nurses
are expected to teach and learners are expected to learn is not always conducive to
carrying out the teaching-learning process.
6.  An absence of third party reimbursement to support patient education programs
relegates teaching and learning to less than high-priority status.
7.  Some nurses and physicians question whether patient education is effective as a
means to improve health outcomes. They view patients as impediments to teaching
when patient do not show interest in changing behavior, when they don’t demonstrate
an unwillingness to learn.
8.  There are multitude of healthcare providers covering much of the same content, but
not necessarily with the consistency.
9.  The type of documentation system used by healthcare agencies has an effect on the
quality and quantity of patient teaching recorded.
PRINCIPLES OF TEACHING:
1.  BEGIN WITH THE END IN MIND

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                 - This means that we must begin our lesson with a clearly defined lesson
objective.  With a clear and specific lesson objective we will have sense of direction. 
We will not lose sight of what we intend to teach.
2.  SHARE LESSON OBJECTIVE WITH STUDENTS
                   - our lesson ought to begin with a statement and clarification of our lesson
objective.  Make known to our students our instructional objective and encourage them
to make the lesson objective their own.  This will serve as their personal targets that will
certainly make them more self- motivated.
3.  LESSON OBJECTIVES MUST BE IN TWO OR THREE DOMAINS- KNOWLEDGE(
COGNITIVE), SKILL (PSYCHOMOTOR) AND VALUES ( AFFECTIVE)
                  -  They are primarily to enhance knowledge, acquisition and honing of skills
and mainly focused on attitude and value formation.
4.  WORK ON SIGNIFICANT AND RELEVANT LESSON OBJECTIVES
                 -  With our lesson objective becoming our students lesson objective, too, our
students will be more self-propelled as we teach.    The level of self-motivation
increases when our lesson objective is relevant to their daily life, hence, significant.
5.  LESSON OBJECTIVES MUST BE ALIGNED WITH THE AIMS OF EDUCATION
AS EMBODIED IN THE PHILIPPINE CONSTITUTION  AND OTHER LAWS AND ON
THE VISION-MISSION STATEMENTS OF THE EDUCATIONAL INSTITUTION OF
WHICH YOU ARE A PART.
                    -    The aims of education as enshrined in our fundamental law of the land,
in the education Act of 1982, the Ten year Medium term development plan must be
reflected in the vision-mission statements of educational institution.  This must filter
down to the course objectives stated in the course syllabi and in lesson objectives laid
down in lesson plans.
6.  FOR ACCOUNTABILITY OF LEARNING, LESSON OBJECTIVES MUST BE
SMART (SPECIFIC, MEASURABLE, ATTAINABLE, RESULT-ORIENTED AND
RELEVANT TIME BOUND AND TERMINAL)
                -  When our lesson is SMART, it is quite easy to find out at the end of our
lesson if we attained our objective or not.  With this, there is greater match between
instruction and assessment. There is CURRICULUM ALIGNMENT
7.  AIM AT THE DEVELOPMENT OF CRITICAL AND CREATIVE THINKING
                    -  This is said more than done.  We need not go into laborious research to
be convinced that the development of critical and creative thinking is wanting in
classrooms.  Our teaching strategies must serve as a catalyst in the development of
HOTS (higher-order-thinking-skills)

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TEACHING METHODS
The following recommendations can help make the lecture approach more effective
(Cashin, 1990):
1. Fit the lecture to the audience
2. Focus your topic - remember you cannot cover everything in one lecture
3. Prepare an outline that includes 5-9 major points you want to cover in one lecture
4. Organize your points for clarity
5. Select appropriate examples or illustrations
6. Present more than one side of an issue and be sensitive to other perspectives
7. Repeat points when necessary
8. Be aware of your audience - notice their feedback
9. Be enthusiastic - you don’t have to be an entertainer but you should be excited by
your topic.
The first and most important step to choosing a teaching method is
To assess the students. This assessment can be formal or informal.
a. Formal assessments include standardized tests, tests from the textbook
or curriculum being used, or teacher-created tests. These assessments can give
you an idea of the previous instruction that the students have received as well as
their academic level. The students in your class may have undergone various
teaching methods and quality of instruction in previous years.
b. Informal instruction is, as the name suggests, much less formal. Good teachers
know their students. If you have been teaching a particular group of students for
some time, you probably already know quite a bit about their interests, ability
levels, and learning styles. If the group of students is new to you, you can make a
point of asking them, individually or in a group, about their interests and
academic strengths. Depending on the age of the children, they may also be able
to write about this, or answer some form of questionnaire about their hobbies,
interests, previous instruction, strengths, and weaknesses. Students generally
enjoy talking about themselves and having their teacher get to know them well,
as it makes them feel special, as well as directing you in choosing your teaching
methods.
Once you have assessed your students, you need to plan for Different Teaching
Methods

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1.      Direct instruction is the most common form of instruction. This is the lecturing
method of teaching. Many teachers use this teaching method almost exclusively, as it
is considered the simplest, and you can cover large amounts of material in a short
period of time. However, this is not the most effective teaching method to reach all
students, especially younger ones, who often need a more engaging, hands-on strategy
in order to learn effectively. In addition, it is hard for teachers to tailor instruction to
students at different levels.
a.     Lecture
-this method was the most widely used instructional strategy in college classrooms.
Although the usefulness of other teaching strategies is being widely examined today,
the lecture still remains an important way to communicate information.
Used in conjunction with active learning teaching strategies, the traditional lecture can
be an effective way to achieve instructional goals.
The advantages of the lecture approach are that it provides a way to communicate a
large amount of information to many listeners, maximizes instructor control and is non-
threatening to students.
The disadvantages are that lecturing minimizes feedback from students, assumes an
unrealistic level of student understanding and comprehension, and often disengages
students from the learning process causing information to be quickly forgotten.
2.     Inquiry-based learning
-is a teaching method which is rapidly gaining popularity in the United States. 
Based on the scientific method, this teaching method can be used virtually for  all
subjects. Using inquiry-based learning takes a lot of time, energy, and planning, but it is
often very effective. Students practice problem solving and critical thinking skills to
arrive at a conclusion.
This teaching method is extremely student-centered and student-directed, and can be
modified for students at any level, reaching them where they are. Teachers will
generally need to start by modeling the process to the students.
3.       Cooperative learning 
-is another teaching method that is considered highly effective when done correctly.
With cooperative learning, students are put in small groups to work together. They are
usually not grouped by ability, but put in a group with children at a variety of levels. The
students are then given tasks to accomplish together. 
Teachers may need to monitor these groups carefully, to make sure they are staying on
task and that all students are participating. This form of instruction also lends itself well
to differentiation, because the teacher can assign specific tasks to children at different
ability levels.

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4.     Information processing strategies
-While it is often advisable to have students really understand the teaching methods,
this strategy teach learners to be good thinkers and not just memorize facts, there are
some cases when facts need to be memorized.
 Facts and concepts may also need to be grouped or organized in order to facilitate
better understanding. Teachers can use various teaching methods to help students with
memorization, or they can use graphic organizers, mind maps, story webs, or other
ways to represent information visually.

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