The learning process involves the generation of new knowledge that changes the way people understand and view activities around them. This learning can be unplanned as in the case of small children developing skills such as feeding themselves. Planned learning involves grown-ups who yearn to learn a given subject and embark on it. The mode of instruction depends on the age of the learners. In this case, clinical educators instruct adult students who have previous experiences (Cooper, Smith & Upton, 2002). Behavioural, cognitive, and adult learning theories have been a guide to clinical educators. They have enabled educators to introduce and teach nursing students effectively. These theories have enabled them to introduce subjects, measure their progress, and get feedback on their level of understanding. They provide a platform for students to gain knowledge, develop understanding, and acquire skills. This simplifies the instruction process for trainers because they are able to pass knowledge and assess the depth of understanding by simply observing (Pritchad, 2009). This paper examines these theories and analyses the roles that they play in the learning process for nursing students.
This paper will discuss the introduction of a course to new nursing students. It will illustrate how behavioural and cognitive theories guide the clinical instructor in developing this course. The adult learning theory will also be outlined as these students are grown-ups. This theory is also applicable for practicing nurses who wish to advance their knowledge. Through this paper, the effectiveness of the three theories in the learning process will be illustrated.
Behavioural Learning Theory
This theory is based on the reaction triggered by a certain stimulus. This response, when repeated over the duration of time, it becomes like a signal to the brain. It is easily communicated to the brain, and the response is automatic despite the level of concentration at the given time. This has been demonstrated by the model of a Russian psychologist, Ivan Pavlov in the early twentieth century. He showed how conditioning occurs by giving dogs food after ringing a bell. This process was continued over time until the sound of the bell made the dogs salivate regardless of whether a food was available or not. Their behaviour changed, and meal times were dictated by the ringing of the bell. This model brings out four stages of learning. Firstly, acquisition of knowledge; in this case, the sound of the bell, meant that food was ready. Secondly, after the conditioning of response, the dogs began salivating even before they saw the food; they could salivate even in cases when food was not available. However, salivating would later stop if the bell was rung and no food was provided for some time. Thirdly, the stimulus becomes general, such that further training is not necessary. This is because a similar signal will still trigger a response. After the continued ringing of the bell and offering food, the availability of food is not the only cause for salivation. This is because the simple ringing of the bell triggers a response. Finally, there is discrimination whereby a different signal, other than the bell, would not trigger a response (Pritchad, 2009).
Thorndike’s research further explained the effect of behavioural change on learning. It indicates that the response triggered by action can either be positive or negative. Rewards improve performance while punishment weakens performance. Therefore, rewards are beneficial while punishing only serves to deteriorate the situation further (Leornard, 2002).
Trainers introducing new students to nursing require this theory to guide them. For fresh students, it requires that medical terms that will involve all areas of nursing should be introduced. According to Pavlov’s model, this is the acquisition stage. The conditioning stage occurs when these terms are used often in explaining different approaches to illnesses and procedures. With continued use of these medical terms and procedures, they become embedded in the students’ minds. In such a situation, the students may become used to nursing and may take further knowledge for granted. This can be compared to Pavlov’s generalisation stage. In this case, students assume that they are already informed and may lack interest in sharpening this knowledge further. This is a weakness of this model. Discrimination can be observed in cases where students may not be willing to research from other sources. They are likely to depend solely on the information provided by the teacher as Pavlov’s dogs would not register any other signal apart from the bell (Pritchad, 2009).
Encouragement of students to excel in their studies either through rewards or recognition of good students can be used to programme learning. This is meant to overcome these weaknesses in Pavlov’s model. For the weak students, this can be addressed by engaging them significantly. This is not like punishing, which may worsen the performance. Encouraging students to read considerably either through research assignments or term papers will reduce discrimination. It will help students explore this acquired knowledge further on their own. Through such research and self-initiated readings, students will be knowledgeable and competent in their studies. These extra activities justify Thorndike’s opinion that behavioural change can be altered positively to get good results (Illeris, 2009).
Skinner’s work introduces learning as programmed to be controlled by conditions. Information is delivered through a step-by-step process that is in order. This means that new concepts can only be introduced once past ones are well understood. Therefore, new knowledge is based on already existing knowledge. External factors are also conditions that affect learning. In this regard, nursing instructors should provide all the necessary resources required for learning. This way, students will be well prepared for learning and will be able to absorb and acquire new knowledge (Pritchad, 2009).
Cognitive Learning Theory
This theory is from the word “cognition”, which refers to the knowing process. It is associated with the Gestalt theorists who differed with behavioural theory by indicating that learning is not based on the single stimulus-response effect. According to them, the response is triggered by several factors that are real; and the person who is experiencing learning is the only one to explain these factors. As opposed to the behavioural theory, external factors do not matter; personal insight and knowledge required are what counts. It has been suggested that people should learn as much as possible, and choose what they need to apply in their lives. Bandura was keen on learning through observation which is a passive mode of learning. Students apply what they have observed to a real situation in measuring their learning progress (Cornings & Barbara, 2005).
This theory concentrates on the brain as the determinant of the capacity of information that can be absorbed. This theory stipulates that individuals should understand new knowledge in their own way (Turner, 2007). For the trainers of nursing, they should understand the individual learning abilities of students. This helps them to know the right approach for every student. It ensures that concepts are well understood before moving to the next level. If a trainer knows each student’s strengths and weaknesses in learning, then the learning process is simplified.
Nursing requires that students obtain theoretical knowledge as well as practical knowledge. As Gestalt theorists suggest, trainers should provide all the theoretical knowledge a student requires. It is up to the student to choose the area of specialization based on self-evaluation. In the case of practical learning, trainers are expected to engage students interactively so that students can learn by observing and enquiring (Cornings & Barbara, 2005).
For an instructor to create new knowledge, existing knowledge is used as the determinant of what should be taught. This is referred to as constructivism; a component of the cognitive theory. This is initiated by the student who outlines the knowledge that they already have on a given subject. The trainer can determine the approach to give according to the student’s level of understanding. The trainer can link the unknown facts with the known facts so as to enable the student to improve the quality of their existing knowledge while still (Schunk, 2004). This is dependent on the trainer’s view of the student’s capability, and this is what determines the next step to take in instructing (Nooteboom, 2009).
According to cognitive theory, knowledge acquired is measured by the ability to transfer. Nursing students first learn the theoretical knowledge and proceed to apply it in practical situations. This is where trainers are able to measure the level of understanding through observation. As discussed earlier, the cognitive approach specializes in what is in the brain. When a student is practicing a learned theory, they do so by transferring what is in mind to a realistic situation. The instructor assists the student by engaging the student and getting feedback on how a student has understood a given concept (Gilbert, 2004).
Adult Learning Theory
Based on the continuous nature of the nursing training, competence is a major trait that all students should demonstrate. It tells whether a student can withstand the challenges such as changes in technology, climate, and ageing (Rothwell, 2008). For nursing students, once they are introduced to this field; it becomes part of their lives requiring that they learn new things every day. This is because the medical knowledge acquired and practice performed in the training college turn over due to the dynamics in the medical world. In this case, procedures change, other forms of medication administration are introduced, and in some cases, some equipment is discarded to pave the way for modern ones.
Teaching adults is simpler as compared to children based on the assumption that they have existing knowledge. However, according to Merriam (2008), adult students require motivation. This can be done by establishing a friendly atmosphere to encourage them to be significantly relaxed to learn. Showing concern and creating a rapport is also necessary to ensure that students can share difficulties experienced (Merriam, 2008).
The good thing about adults is that they have their own, self-initiated free will to learn. This is indirectly affected by the goals that they have set, as well as the relevance of the study that is due to the applicability it has on their work. They do not learn solely for knowledge, but to practice in their work too (Cornings & Barbara, 2005).
Adult learning theory is focused on developing meanings from perspective. The students want to establish the relationship between their work and the concepts that are learned (Brookfield, 2005). In the case of nursing students, it is expected that instructors concentrate on relating the experience that these students have while working with the new knowledge. This can be explained by the pedagogy view in which learners analyse situations as per their desire to fight existing injustices or oppressive actions in their field. On the other hand, bigotry is considerably practical and is applied in the working situation where great details are required so as to learn (Brookfield, 2005). When these two views are combined in instruction, instructors can quench the students’ thirst for knowledge on the applicability of theories in their work experience.
The nursing field involves repetitive procedures, which eventually become part of a physician’s daily life. However, with the dynamic changes that are being experienced in the medical world, nurses should continue learning to keep up with these changes. The learning theories are applicable during the introduction stage as is the case with new students. Trainers still require these theories to assist nurses who are practicing and/or interested in advancing their knowledge. Such nurses are adults, and this requires trainers to use the adult theory approach so as to instruct effectively. If instructors integrate these theories, they can cater to both fresh students and experienced nurses. This ensures that nurses are competent in their profession and able to move with the modern times.
Brookfield, S.D. (2005). The power of critical theory for adult learning and teaching. Maidenhead: Open University Press.
Cooper, P., Smith, C.J. & Upton, G. (2002). Emotional and Behavioural Difficulties: Theory to Practice. New York: Routledge.
Cornings, J. & Barbara, G. (2005). Review of Adult Learning and literacy, Volume 5: Connecting research, Policy and practice. New Jersey: Lawrence Erlbaum Associates, Inc. Publishers.
Gilbert, P. (2004). Evolutionary theory and cognitive therapy. New York, NY: Springer Pub. Co.
Illeris, K. (2009). Contemporary Theories of Learning: Learning Theorists in Their own words. New York: Routledge.