Stages in Learning,

Physical Environment
and Well Being
 Objectives

In this unit the learner will develop an understanding
of the:
 Developmental stages and learning, experiential
learning
 Impact of state of physical health on learning
Emotional aspect including stress
 Physical environment conducive to learning in
addition wellbeing and learning including
behavioral, cognitive, humanistic and dialectical
(interactive) learning theories.
 Learning

 It is the life long, dynamic process by which
individuals acquire new knowledge or skills and
alter their thoughts, feelings, attitudes, and actions.
 The learning theories

 Behaviorist learning theory

 Cognitive learning theory

 social learning theory

 Psychodynamic learning theory

 Humanistic learning theory

 Behaviorist Learning
 Behaviorists view learning Theory
as the product of the
stimulus conditions (S) and
the responses (R).
 Behaviorists closely observe
responses and then
manipulate the environment
to bring about the intended
change.
 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.
Consider an example from health care:

Someone without much experience with hospitals may visit a sick relative . While in
the relative’s room, the visitor may smell offensive odors and feel queasy and light-
headed . After this initial visit and later repeated visits, hospitals may become
associated with feeling anxious and nauseated, especially if the visitor smells odors
similar to those encountered during the first experience.

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.

Another example is:

The assumption is that fear of a particular stimulus or situation is learned, so it can,
therefore, be “unlearned”. Fearful individuals are first taught relaxation techniques.
While they are in a state of relaxation, the fear-producing stimulus is gradually
introduced at a nonthreatening level so that anxiety and emotions are not aroused. After
repeated pairings of the stimulus under relaxed, non frightening conditions,
the individual learns that no harm will come to him or her from the once-fear-inducing
stimulus. Finally, the client is able to confront the stimulus without being anxious and
afraid.
 CRITICISM

 The behaviorist theory is simple and easy to use, and it encourages
clear, objective analysis of observable environmental stimulus
conditions, learner responses, and the effects of reinforcements.
HOWEVER

Under this model, learners are assumed to be relatively

passive and easily manipulated, which raises the crucial issue of ethics:
“Who” is to decide “what” the “desirable” behavior should be?

Another short coming of behavior modification programs is that

clients’ changed behavior may deteriorate over time, especially once
they are back in their former environment.
 Cognitive learning
theory

 While behaviorists generally ignore the
internal dynamics of learning, cognitive
learning theorists stress the importance
of what goes on “inside” the learner.
 The key to learning and changing is the
individual’s cognition (perception,
thought, memory, and ways of
processing and structuring
information).
 A highly active process largely directed
by the individual, learning involves
perceiving the information, interpreting
it based on what is already known, and
then reorganizing the information into
new insights or understanding.
Cognitive theorists, unlike behaviorists, maintain that reward is not necessary for
learning. More important are learners’ goals and expectations, which create
disequilibrium, imbalance, and tension that motivate them to act.

In general, cognitive psychologists note that memory processing and the retrieval of
information are enhanced by organizing information and making it meaningful.

Gagné and his colleagues outlined nine events and their corresponding cognitive
processes that activate effective learning (Gagné, Briggs,& Wagner, 1992):

• Gain the learner’s attention (reception)

• Inform the learner of the objectives and expectations (expectancy)
• Stimulate the learner’s recall of prior learning (retrieval)
• Present information (selective perception)
• Provide guidance to facilitate the learner’s understanding (semantic encoding)
• Have the learner demonstrate the information or skill (responding)
• Give feedback to the learner (reinforcement)
• Assess the learner’s performance (retrieval)
• Work to enhance retention and transfer through application and varied practice
(generalization)
 CRITICISM

 Because cognitive theory was criticized for
neglecting the social context, the effects of social
factors on perception, thought, and motivation are
receiving increased attention.
 Social Learning Theory

 Most learning theories assume that the individual must
have direct experiences to learn.
 According to early social learning theory, much of
learning occurs by observation—watching other people
and discerning what happens to them.
 Learning is often a social process, and other individuals,
especially “significant others,” provide compelling
examples or role models for how to think, feel, and act.
 It is the combination of behaviorist, cognitive and social
cognition dimensions of the theory.
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. The major difficulty is that this theory is complex
and not easily operationalized, measured, and assessed.
 CRITICISM

 Weaknesses of this theory are that it does not take into
account individual interpretations of situations, it
does not relate to all behavioral differences, and it
focuses more on what is happening in the situation
rather than explaining why the situation is occurring.

(https://www.bartleby.com/essay/Strengths-And Weaknesses-Of-Social-Learning-Theory-
PCGFPTZPQ6#:~:text=Weaknesses%20of%20this%20theory%20are,why%20the%20situation
%20is%20occurring.)
 Psychodynamic
Learning
 Theory
 A theory of motivation stressing emotions rather than cognition and
responses, the psychodynamic perspective emphasizes the importance of
conscious and unconscious forces in guiding behavior, personality
conflicts, and the enduring effects of childhood experiences.

A central principle of the theory is that behavior may be conscious or

unconscious—that is, individuals may or may not be aware of their
motivations and why they feel, think, and act as they do.

According to the psychodynamic view, the most primitive source of

motivation comes from the id and is based on the basic instincts, impulses,
and desires we are born with, which includes eros (the desire for pleasure
and sex, some times called the “life force”) and thanatos (aggressive and
destructive impulses, or “death wish”).
 CRITICISM

 One problem with the psychodynamic approach is that
much of the analysis is speculative and subjective.
Health professionals’ biases, emotional conflicts, and
needs may distort their evaluation of other persons and
situations.
 Another caution is that the psychodynamic theory
may be used inappropriately; it is not the job of health
professionals with little clinical psychology or
psychiatric training to probe into the private lives and
feelings of patients so as to uncover deep, unconscious
conflicts.
People learn to take the long road to pleasure and to weigh the choices or dilemmas
in the conflict between the id and superego. Healthy ego (self) development, as
emphasized by Freud’s followers, is an important consideration in the health fields.
For example: patients with ego strength can cope with painful medical treatments
because they recognize the long-term value of enduring discomfort and pain to
achieve a positive outcome. Patients with weak ego development, in contrast, may
miss their appointments and treatments or engage in short-term pleasurable
activities that work against their healing and recovery. Helping patients develop ego
strength and adjust realistically to a changed body image or lifestyle brought about
by disease and medical interventions is a significant aspect of the learning and
healing process.
 Humanistic learning
theory

 Underlying the humanistic perspective on learning is the
assumption that each individual is unique and that all individuals
have a desire to grow in a positive way.
 The importance of emotions and feelings, the right of individuals
to make their own choices, and human creativity are the
cornerstones of a humanistic approach to learning.
 From a humanistic perspective, motivation is derived from each
person’s needs, subjective feelings about the self, and the desire to
grow. The transfer of learning is facilitated by curiosity, a positive
self-concept, and open situations where people respect
individuality and promote freedom of choice. Under such
conditions, transfer is likely to be wide spread, enhancing
flexibility and creativity.
 
 Humanistic psychology contends that feelings and emotions
are the keys to learning, communication, and understanding.
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 has also been found to be well suited to
working with children and young patients undergoing
separation anxiety due to illness, surgery, and recovery.
Within this perspective, a principal emphasis is on client-
centered medicine and the need for health professionals to
learn and grow from their healthcare experiences.
 CRITICISM

 The theory has been criticized
for promoting self-centered
learners who cannot take
criticism or compromise their
deeply felt positions. Charged
with being more of a
philosophy—or a cult—than a
science, the “touchy-feely”
approach of humanists makes
some learners and educators
feel truly uncomfortable.
 Moreover, information, facts,
memorization, drill, practice,
and the tedious work
sometimes required to master
knowledge, which humanists
minimize.
Learning Assumptions About Educator’s Sources of Transfer ofP
Environmental BEHAVIORIST
Passive,reactice Practice;
stimulus conditions
learner Active educator similarity in
and reinforcement Drive reduction.
responds to manipulates stimuli stimulus
promote changes in
environ- and reinforcement to conditions and
responses.
mental direct learning and responses
To change behavior, conditions change. between
change the (stimuli and learning and
environment. reinforcement new
). COGNITIVE situations.
Internal perception Active educator
and thought Active learner Goals. Mental and
structures
processing within deter- mines experiences (through Expectatio physical
context of human patterning of organization and ns. activity.
development experiences; is meaningfulness) to Disequilibr Common
promote learning strongly encourage the patterns.
and change. ium.
influenced by reorganization of Understading.
To change attributions. cognitions. Learning to
behavior, learn.
change
cognitions. SOCIAL LEARNING
Active educator
models behavior,
External role models encourages
and their perceived Socializatio
Active learner perception of n experi
reinforcement along reinforcement,
with learner’s observes others ences, role
carefully evaluates
internal influences. and regulates learning materials for models, Similarity of
To change behavior, decision to social messages, and and self- setting and
change role models, reproduce attempts to influence reactive role models’
perceived learner’s self- influences behavior.
behavior.
reinforcement, and the regulation. (observe
learner’s self- self, set
regulating goals, and
Learning Assumptions About Educator’s Sources of Transfer ofPr

Internal forces such Active learner’s PSYCHODYNA Pleasure Personality

as developmental lifestyle, past MIC principle conflict,
experiences, and reality resistance,
stage, childhood Educator as a
and current reflective principle. and transfer-
experiences, emotional con- ence
emotional conflicts, interpreter makes Imbalance.
flicts influence associated
and ego strength sense of learner’s Conscious
what is personality and with
and
influence learning learned and learning
motivation by lis- unconsciou
and change. how it is situations
tening and posing s influence
To change remembered questions to may act as
of
behavior, change and per- barrier.
stimulate con flict,
interpretations formed. conscious developme
and make awareness, nt, and
unconscious insight, and ego defense
motivations strength. mechanism
conscious. s.

HUMANISTIC
Internal feelings Active learner Positive or
about self, ability attempts to Facilitative
educator Needs, negative
to make wise actualize feelings
choices, and potential for encourages desire for
positive self- about self
needs affect positive self- positive self- and free
learning and growth and growth, listens growth, and
empathetically, dom to learn
change. confirm self- confirmation promote or
concept; is allows freedom of
To change choice, and of self inhibit
behavior, spontaneous, concept. transfer.
creative, and respects learner.
change feelings,
self- concept, playful.
and needs.
 

ERICK ERICSON’S
developmental stages
 References

 Nurse as Educator Principles of Teaching and
Learning for Nursing Practice Second Edition Susan
B. Bastable State University of New York.( chapter 3:
Applying Learning Theories to Healthcare Practice,
page: 45 to 69)