APPLYING THEORIES OF LEARNING TO HEALTH CARE PRACTICE

BASIC PRINCIPLES
DEVELOPMENT

MATURATION

HUMAN DEVELOPMENT
Physical Psychological Social Spiritual Emotional constitution

( womb to tomb)

Scientific study of changes that occur in people as they age or grow older in years.

CHANGES
1. Growth quantitative Increase in the size

2.

Development

qualitative

Gradual changes in character

TWO MAJOR PROCESS

1.

Learning

2.

Maturation

1. LEARNING
Permanent

change in behaviour.
by the environment.

Influenced

Complex

process
birth to death

Changes in mental processing Development of emotional functioning Social transactional skills

2. MATURATION
Bodily

changes

Result

of hereditary or the traits that a person inherits from his parents inherited biological patterns are reflected in maturation

Preprogrammed

OVERVIEW OF LEARNING THEORIES

Theorist
JOHN WATSON

Description
Learning is a result of conditioning and experiences; it is encourage by changing the environment. The learner is passive, controlled by the environment.

IVAN PAVLOV

B. F. Skinner Teaching is the deliberate manipulation of the environment

EDWARD L. THORNDIKE

Learning can be transferred from one situation to another. Assessment of learners behaviour is necessary. The learner must have an understanding of the goals. Education should promote learners independence. Learning by doing Learning is affected by the culture and value system. The learner is an active participant in the learning process. discovery learning

JOHN DEWEY

JEROME BRUNER

ROBERT GAGNE

ALBERT BANDURA

Learning occurs in an orderly fashion ,from the simple to the complex, from the concrete to the abstract. conditions of learning Behaviour is regulated by internal mechanisms such as SELF EFFICACY

1. BEHAVIORIST LEARNING THEORY

S-R

model (stimulus response) Watson & Guthrie

John

Contiguity theorists

Thorndike

& Skinner

Reinforcement theorists

2. COGNITIVE LEARNING THEORY

Cognitive

science is the study of how our brains work in the process of perceiving, thinking, remembering and learning (information processing)

Learning

from a cognitive perspective is an active process in which the learner constructs meaning based on prior knowledge and view of the world.

Ausubel(1963)
Subsumption

Theory of Meaningful Verbal

Learning
Meaningful

learning is thought to occur only if existing cognitive structures are organized and differentiated.

3. SOCIAL LEARNING THEORY

Albert

Bandura (1977) social cognitive theory

Modeling Attentional processes Retention processes

People learn through:

LEARNING THROUGHOUT THE LIFE SPAN

Childrens readiness for learning (Evidence of willingness to learn) varies during childhood according to maturational level.
YOUNG

CHILDREN learn primarily through

play Puppets Toys Coloring books

 OLDER

CHILDREN can also benefit from the use of art materials and medical supplies
Medicine

cups Putting bandages on dolls

GUIDELINES FOR TEACHING CHILDREN

Make

sure that the client is comfortable. Encourage caregiver participation. Assess the developmental level. Assess the clients chronological status readiness and motivation. Assess the clients psychological status Determine self care abilities of client and care giver.

Use play, imitation and role playing to make learning fun and meaningful. Use different visual stimuli such as books, chalkboards and videos to convey information and check understanding. Use terms that are easily understood by the client and caregiver. Provide frequent repetition and reinforcement. Develop realistic goals that are consistent with developmental abilities. Verify clients understanding of information presented

ADOLESCENTS
Reading

skills and comprehension ability have advanced and can understand more complex information. Peer support -strongest influences. Nurse must act as a role model and relate to adolescent on their level. Teaching, focus on the present and be aware of their need to maintain control. Encourage independence as possible.

GUIDELINES FOR TEACHING ADOLESCENTS

Show

respect by recognizing that they still have to gain the knowledge and experience of adulthood while struggling to break away from the grasp of childhood. Boost confidence by asking their input and opinions on health care matters. Encourage to explore their own feelings about self concept and independence. Be sensitive to the peer pressure they are facing.

 Help

identify their positive qualities and build on those Use language that is clear yet appropriate to the health care setting Gear teaching developmental level. Engage them in problem solving activities to encourage independent and informed decision making.

OLDER ADULTS
Some

have perceptual impairments such as impaired vision and hearing. Provide large print written materials Make sure that the client can hear all your instructions and directions

GUIDELINES FOR TEACHING OLDER ADULTS

Offer

positive reinforcement for every attempt to participate. Use silence as a reflective tool to allow learners additional time to process information. Encourage reflection, particularly when sensitive issues are being discussed. Stimulates both visual and auditory senses in the presentation of the material to increase the probability that content matter will be retained.

 Use

a variety of teaching methods, such as role-playing, games examples, open discussion, charts and reading materials. Use true/false, multiple-choice, or openended questions to evaluate progress. Ask specific questions designed to elicit a response such as, Do you have any questions? Utilize the older learners experience and expertise.

THEORIES OF HUMAN DEVELOPMENT

1.

THEORY OF PSYCHOSEXUAL DEVELOPMENT

Sigmund Freud (Father of Modern Psychology) Human beings pass through series of stages Must be able to resolve conflicts that each stage poses before can move on the next higher stage. Failure to resolve the conflict results to frustration and develops fixation and frails to move on to the next stage of development.

2. ERICKSONS PSYCHOSOCIAL STAGE OF DEVELOPMENT

Each stage has a unique developmental task or dilemma that must be resolved:

CRISIS a turning point, crucial period of increased vulnerability and heightened potential. - developsHEALTHY PERSONALITY by mastering lifes outer and inner dangers. EPIGENETIC PRINCIPLE personality continues to develop through out the entire life span.

8 MAJOR STAGES OF PSYCHOSOCIAL DEVELOPMENT

1.

INFANT: Trust vs. Mistrust (birth to 1 year) Needs must be met

RESOLUTION - results to
development of trust

NON-RESOLUTION development of mistrust and fear of the future and suspicious mind

II. TODDLER : AUTONOMY VS. SHAME AND

DOUBT
The

(2-3 YEARS)

conflict is whether to assert their wills or

not
RESOLUTION

acquire sense of

independence and competence when parents are patient and encouraging.

NON-RESOLUTION

develop excessive

shame and doubt when parents are overprotective and always curtail their childs freedom of movement.

III. PRESCHOOL: INITIATIVE VS. GUILT (4-5 YEARS OLD)

Development of mental and motor abilities RESOLUTION: Children develop initiative if parents allow them freedom to run, slide play with other children, go biking. NON-RESOLUTION: Children develop a sense of emptiness or inadequacy and feel that they are mere intruders or isturbo and pasaway they become passive recipients of whatever the environment brings.

IV. SCHOOL AGE: INDUSTRY VS. INFERIORITY (6-11 YEARS OLD)

Childs

concern is how things work and how they are made Children gain a sense of accomplishment if their efforts are recognized or rewarded. Acquire a sense of inferiority if parents/teachers rebuff, ridicule, constantly scold or ignore the childs effort to improve.

RESOLUTION:

NON-RESOLUTION:

V. ADOLESCENCE: IDENTITY VS. ROLE CONFUSION (12 18 YEARS OLD)

Experience

psychological revolution.

RESOLUTION:

Establishment of integrated and coherent image of oneself as a unique person resulting to a sense of centered identity

NON-RESOLUTION:

Role confusion or negative identity like a hoodlum or delinquent.

VI. YOUNG ADULTHOOD: INTIMACY VS.

ISOLATION
Intimacy:

The capacity to reach out and make contract with other people. Results to withdrawal, isolation and formation of shallow relationships

Rejection:

VII. MIDDLE ADULTHOOD: GENERATIVITY VS. STAGNATION

Generativity : Entails selflessness

Stagnation: People are

preoccupied with their material possessions or physical well being.

VIII. OLD AGE: INTEGRITY VS. DESPAIR

Towards

twilight years, people tend to take stock of their lives or do a self-accounting. of satisfaction

Accomplishments: Sense

Despair: So much to do, so little

time

3. PIAGETS THEORY OF COGNITIVE DEVELOPMENT

Universal

constructivist Perspective

The

child constructs reality by interacting with the environment and that children have predictable qualitative differences in how they think about things at different ages.

4. THEORY OF MORAL DEVELOPMENT BY : KOHLBERGS (1958)

theory holds that moral reasoning, the basis for ethical behavior.

The

1. Level 1 (Pre-Conventional)

Stage 1:Obedience and punishment orientation (How can I avoid punishment?) Stage 2:Self-interest orientation (What's in it for me?) (Paying for a benefit)

2. Level 2 (Conventional)

Stage 3: Interpersonal accord and conformity (Social norms) (The good boy/good girl attitude) Stage 4: Authority and social-order maintaining orientation (Law and order morality)

3. Level 3 (Post-Conventional)

Stage 5: Social contract orientation Stage 6: Universal ethical principles (Principled conscience)

DETERMINANTS OF LEARNING
1. Learning needs what the learner needs and wants to learn
2. Readiness to learn when the learner is receptive to learning 3. Learning style how the learner best learns

1. LEARNING NEEDS

Gaps in knowledge that exist between a desired level of performance and the actual level of performance.
( Healthcare Educ. Association,1985)

STEPS IN THE ASSESSMENT OF THE LEARNING NEEDS:

1.

2.
3. 4. 5. 6. 7.

8.
9.

Identify the learner Choose the right setting Collect data about the learner Collect data from the learner Involve members of healthcare team Prioritize needs Determine the availability of educational resources Assess demands of the organization Take time-management issues into account

METHODS TO ASSESS LEARNING NEEDS:

1.

2.
3. 4. 5. 6. 7.

Informal conversations Structured interviews Focus group Self-administered questionnaires Tests Observations Patient Charts

2. READINESS TO LEARN
The

time when the learner demonstrates an interest in learning the information necessary to maintain optimal health or to become more skillful in a job.

 Indicators

of readiness to learn:

receptiveness willingness
Ability to learn

4 TYPES OF READINESS TO LEARN:

Physical readiness

Emotional readiness

Experiential readiness

Knowledge readiness

3. LEARNING STYLE
The

ways in which, and conditions under which, learners most efficiently and most effectively perceive, process, store and recall what they are attempting to learn and how they prefer to approach different learning tasks.

PURPOSE:
To

be able to determine when to intervene if difficulty occurs among learners and to enhance effectiveness of learning and to make it even better.

LEARNING STYLE MODELS:

1.

Holistic (global) thinkers

- want to see broad categories at details. before they look

- learners retain an overall or global view of information.

2.

Analytic thinkers

perceive information in an objective manner and do not need to connect it to their personal values or experiences.
-

3. Verbal

Approach

- learners represent in their brains information they read, see or hear in terms of words or verbal associations.

4. Visual approach

- learners can greatly grasp information they read, see or hear in terms of mental picture or images.

IF A CHILD LIVES WITH LOVE.

If a child live with criticism, He learns to condemn; a child lives with hostility, He learns to fight; a child lives with ridicule, He learns to be shy; a child lives with tolerance, He learns to be patient;

If

If

If

 If

a child live with encouragement, He learns confidence; a child lives with praise, He learns to appreciate; a child live with fairness, He learns justice;

If

If

If

a child lives with security, He learns to have faith;

 If

a child live with approval, He learns to like himself;

If

a child lives with acceptance and friendship, He learns to find love in the world. a child lives with love, He grows up to be a good and loving person. (From a popular poster)

If