Learning Theories 1

Utilization of Learning Theories in Nursing Education

Melonie Hilton, Angela Preston, Natalie Starkey, and Paula Wyman
NURS 5327: Nursing Education Curriculum Development
University of Texas Tyler
June 16, 2014

Learning Theories 2
Utilization of Learning Theories in Nursing Education
Learning theory embraces a multitude of approaches to understand and foster learning.
Handwerker (2012) reports the complexity of nursing and increasing demands on nursing today
demand improvement in nursing education to smooth the transition from student to nurse.
Nursing educators are challenged to improve the educational process to better prepare students to
enter the practice area. This paper will discuss the application of six different theories of learning
in nursing education. Comparison of the theories will be explored as well as a few strengths and
weaknesses of each.
Learning Theories
Behaviorism
The principal unit of analysis in behaviorism is the habit defined as the consistent and
coordinated act that develops in a given situation through repetition. (Moore, 2011, p. 451)
Behaviorists promote the idea that what occurs repeatedly becomes a learned behavior, whether
one is aware of the behavior or not. Pavlov demonstrated this through animal reflexology.
Watson added to Pavlovs work by means of classical conditioning. Educators employing
behaviorism theory have well planned curriculum intent on producing positive tangible
behavioral changes. Such curriculum and clear outcome measures are helpful in meeting the
stringent requirements of accrediting bodies (Handwerker, 2012). The problem with
behaviorism is that the theory is teacher centered and students are often overwhelmed with the
mass of information received in the classroom.
Cognitivism
Cognitivism takes the focus back to the learners brain, knowing that what is observed is
a consequence of the thinking going on inside the mind. Learning is viewed as a change in
mental processes or associations (Oermann, 2015, p. 8). Mayer focused on using pictures and
Learning Theories 3
words to process information and highlighting how senses, words, and pictures are used in
conjunction to interpret the information one receives in the brain (Mayer, 2001). Flash cards with
pictures showing how a disease affects the patients body are helpful for memory retention and
can be demonstrated through nursing students test scores who use them to study. This is helpful
in providing nursing students with new information and guiding teachers to build upon prior
experiences to carry the new information into their inner world of knowledge (Utley, 2011). One
weakness to this theory is the struggle with continuity and discontinuity. Individuals can progress
from one stage to the next at a highly variable rate depending on prior experiences.
Social Cognitivism
Social cognitivism promotes the idea that all learning occurs within the context of social and
cultural interactions with the use of observation, imitation, and modeling (Oermann, 2015).
Observation can allow for a more efficient way of learning about behaviors and their results than
personal trial and error (Bahn, 2001). The student can watch multiple others role model certain
behaviors and then make decisions about which behaviors to adopt or not depending on their
own values and perception of the results of those actions. Students can watch and then perform
guided practice to learn more complex behaviors (Bahn, 2001).
In nursing education, the student can use social learning to observe both instructors and
preceptors and learn clinical skills as well as professional values and attitudes. The student does
not only imitate what is seen but acquires new behavioral patterns and cognitive skills as they
model what they learn (Bahn, 2001). This can be a great strength with continued guided practice
as they build essential skills with repetition. This can also be a great risk as the quality of their
learning is greatly influenced by the quality and values of the observed model. If incorrect or
inappropriate actions are modelled without adverse effect, then the student learns that this is the
accepted practice (Bahn, 2001). This practice can lead to unsafe and even unethical nursing.
Learning Theories 4
Humanism
With humanism, learning is a process of self-actualization (Oermann, 2015). Students and
teachers are collaborators in the learning process where the acquisition of knowledge is only a
means to a goal (Csokasy, 2002). The teacher facilitates learning experiences and success is
graded on the students grasp of the desired concepts not on criterion referenced grades
(Csokasy, 2002). In nursing schools this is often achieved through the use of discussions,
discovery opportunities, group participation and portfolios. While this can be seen to strengthen
the students learning experience through deeper understanding, it can also be very time
consuming for faculty to establish the validity of these methods in meeting the standards of their
accrediting bodies (Csokasy, 2002).
Constructivism
Constructivism defines learning as an active process that acquires knowledge by previous
experiences and builds upon past experiences from the environment. Constructivism theorists
include Dewey, Piaget, Kolb and Fry. Examples of teaching methods using constructivism
include case studies, research projects, simulation, and guided experimentation (Oermann, 2015).
All of these teaching methods are beneficial to a nursing student. Case studies are an excellent
tool in nursing education to allow a student to identify a scenario and even recall similar
situations. This would allow a learner to build upon previous knowledge. In fact, a strength of
constructivism is that learners are able to tackle real life circumstances by being able to relate to
previous situations (Nagowah, 2009).
A study conducted by Duane and Satre (2014) used constructivism teaching methods
among nursing students and found that a large number of the students have indicated that
collaborative testing feedback helped their learning, increased critical thinking, increased
Learning Theories 5
retention, and increased accountability. One weakness of constructivism is that a younger
nursing student has limited past experiences to build on.
Brain-based learning
Brain-based learning is a newer theory that has developed based on brain research that
has occurred over the last twenty years. Neuroscientists report that learning changes the brain by
creating more synapses. This is thought to occur due to neurons repeatedly firing during the
process of learning. The theory emphasizes the need for low stress environments that encourage
communication and social interaction (Freeman & Walsh, 2013). Jensens table (as presented in
Oermann, 2015) lists several brain-based learning teaching strategies including, exposing
learners to content one week before a lesson, teaching focused on main concepts, providing
feedback during class, social and physical engagement, and celebrating success.
Brain-based learners have a higher retention of material when doing something that is
engaging. According to Nwokah and Leafblad (2013) because the brain benefits from new and
multisensory experiences, opportunities to practice newly acquired skills in a novel environment
are more likely to result in consolidation of learning and increase in remembering (p. 71). This
type of learning could be hard to utilize in a large classroom setting.
Contrast and comparison
Each of the learning theories has their value in nursing education. There is also overlap
and opposition between the theories. Behaviorism is teacher centered and depends on concrete
outcomes to assess the effectiveness of teaching (Handwerker, 2012). In contrast, constructivism
sees learning as a cerebral process whereby new knowledge is added to pre-existing knowledge
via experiences. Constructivism is a learner centered active process through which experiential
Learning Theories 6
learning is supported. Use of such theory for nursing education reportedly better prepares
students for real life critical decision making (Handwerker, 2012).
Social Cognitivism views learning as a reciprocal process between the environment and
learner. Learning is thought to be achieved when the learner has been socialized
into the culture and feels empowered to act in the culture (Bahn, 2001). This differs from
humanism where learning is believed to be an internally driven process. Unlike other theories,
for humanism learning is not the goal but only a means to fulfill the learners potential
(Oermann, 2015).
Cognitivism and Constructivism have some similarity in that both view learning as an
active process where knowledge is acquired by building on past experiences. Both theories
involve bidirectional communication and interaction between students and instructors (Oermann,
2015). Brain-Based Learning is action oriented as well. For this theory success is experienced
by the learner through feedback and real world outcomes (Freeman & Walsh, 2013).
No solitary theory is adequate to prepare nurses for the current health care environment.
Educators are implored to create learning environments that utilize multiple theories to enable
nurses to assimilate information and demonstrate clinical reasoning required for practice
(Handwerker, 2012).



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References
Bahn, D. (2001). Social learning theory: its application in the context of nurse education.
Nurse Education Today, 21, 110-117. doi:10.1054/nedt.2000.0522
Csokasy, Judie (2002). A congruent curriculum: Philosophical integrity from philosophy to
outcomes. Journal of Nursing Education, 41(1), 32-33.
Duane, B. T., & Satre, M. E. (2014). Utilizing constructivism learning theory in collaborative
testing as a creative strategy to promote essential nursing skills. Nurse Education Today,
34(1), 31-34. doi:10.1016/j.nedt.2013.03.005
Freeman, G.G. & Wash, P.D. (2013). You can lead students to the classroom, and you can make
them think: Ten brain-based strategies for college teaching and learning success. Journal
of Excellence in College Teaching, 23(3), 99-120.
Retrieved from www.celt.muohio.edu/ject/
Handwerker, S.M. (2012). Transforming nursing education: A review of current curricular
practices in relation to Brunners latest work. International Journal of Nursing Education
Scholarship 9(1), 1-16. doi:10.1515/1548-923X.2510
Mayer, R. E. (2001). Multimedia learning. New York: Cambridge University press.
Moore, J. J. (2011). Behaviorism. Psychological Record, 61(3), 449-465. Retrieved from
http://thepsychologicalrecord.siu.edu
Nagowah, L., & Nagowah, S. (2009). A reflection of the dominant learning theories:
behaviorism, cognitivism, and constructivism. International Journal of Learning, 16(2),
279-285. Retrieved from www.Learning-Journal.com
Nwokah, E. E., & Leafblad, S. (2013). Service Learning to Promote Brain-Based Learning in
Undergraduate Teaching. Journal on Excellence in College Teaching, 24(3), 69-98.
Retrieved from www.celt.muohio.edu/ject/
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Oermann, Marilyn H. (2015). Teaching in nursing and the role of the educator. New York, NY:

Springer Publishing Company, LLC
Utley, R. A. (2011). Theory and research for academic nurse educators: Application to
practice. Sudbury, Mass: Jones and Bartlett Publishers.