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Contributions of Major Learning Theories in Shaping Nursing Education A PaperSubmitted in Partial Fulfillment of the RequirementsFor NURS 5327In the College of NursingThe University of Texas at TylerBy Kristi Burns, Stephanie Crowe, and Tracy Nash June 16, 2014Contributions of Major Learning Theories in Shaping Nursing Education In order to understand how to be an effective teacher, it helps to understand how people learn. There have been many theories on how the human brain learns and these theories have evolved since the middle of the 19th century when people started to study learning. The major theories of behaviorism, cognitivism, social cognitivism, humanism, constructivism, and brain-based learning have been studied and developed by some of the leading theorists of our time. Psychology, medicine, nursing, and teaching have all benefited from the theories proposed by Ivan Pavlov, B.F. Skinner, Abraham Maslow, Carl Rogers, and many others. In this paper we will explore how their contributions and theories have helped shape what we know about learning and specifically how this applies to educating nurses.Six Major Nursing TheoriesSocial CognitivismOverview. Social Cognitivism was an expansion on Piaget’s cognitive theory and was first proposed by Lev Vygotsky (Oermann, 2015). This theory emphasizes the idea that learning is a social process and places value on a person’s cultural background, language, and human interactions and how that impacts the way he or she learns (Oermann, 2015). The idea of “zone of proximal development” explains the way students learn best by using their existing knowledge of a subject, then expanding that knowledge to learn something new with the help of a teacher or mentor (Oermann, 2015). Albert Bandura (1977) expanded on this idea of social cognitivism and pointed to observational learning, imitation, and modeling as the major components in how one learns (as cited in Oermann, 2015). In a sense, social cognitivism recognizes that humans are social creatures and that we can not only learn from the actions we perform daily, but also by interacting with others. Using social cognitivism in nursing education is an idea that differs slightly from the way we traditionally teach students. In a study of medical students working daily in a rural clinical setting, Daly, Roberts, Kumar, & Perkins (2013) found that students progressed from a theoretical learner to knowing clinical skills. In addition students reported more active engagement socially and developed a stronger clinical identity. This study is an important contrast in how we currently teach nursing and medical students with traditional lecture, then separate clinical learning by department and short term clinical exposure. The study by Daly et al. (2013) allowed students to use the geography of a rural clinical setting and their long-term presence in the clinic to be exposed to many different clinical situations with expert supervision. This encouraged students to take ownership in patient care. Strengths and weaknesses. Social cognitivism has strengths and weakness in regards to nursing education. The benefit of social interaction and hands on experience when learning a new skill is valued in medicine and nursing. Seeing, repeating, and doing is a very effective way to learn for many students and so much more applicable than just reading about it in a book. Daley et al. (2013) indicate strengths of this method include students developing their own self-confidence and self-efficacy. On the other hand, a weakness of using this method is the very fact that it is a social relationship. Daly et al. (2013) admitted that learning is dependent on the student -supervisor relationship and some variability was noted depending on the different supervisor relationships. Social cognitivism is dependent on social interaction, so it is important for mentor and student to have a good rapport. Oermann (2013) suggests activities such demonstration and return demonstration, observational learning, and role modeling as some methods for teaching using the social cognitivism theory. The theory of social cognitivism is a shift from the paradigm of cognitivism and seeing learning as just an internal process. Learning can occur in different environments and is a constant flow of social interactions, knowledge and pushing the boundaries of what one knows.HumanismOverview. Within the humanist framework, learning is viewed as a personal act necessary to achieve the learner’s full potential (Schunk, 2012). The goal of this approach is for the learner to become autonomous and self-directed (Rostami & Khadjooi, 2010). Two major contributors of humanism are Abraham Maslow and Carl Rogers. Maslow developed the Hierarchy of Needs theory, determining that most human actions are based of hierarchical needs, with lower order needs taking precedence over higher order needs (Oermann, 2015). Rogers concluded that for people to grow, “they need an environment that provides genuineness, acceptance, and empathy” (Oermann, 2015, p. 19). Examples of teaching methods based on humanism include participatory and discovery methods, allowing students choices and opportunities for their learning, and providing resources and encouragement for learning (Oermann, 2015).??????????????? Strengths and weaknesses. A strength of this theory is that it permits the student and teacher to work together as nurses do in clinical practice. It stresses the importance of holistic learning, which can translate over to holistic care of the patient (Halarie, 2005). This approach also promotes the opportunity for developing skills necessary for lifelong learning, which are important to nursing students as they step into a career that is constantly changing (Halarie, 2005). Moreover, it offers numerous opportunities to learn and develop skills on a daily basis. This style of learning also has its weaknesses. One of the biggest criticisms is that it fosters self-centeredness in learners and does not prepare students to appreciate the benefits of constructive criticism (Butts & Rich, 2011). Throughout nursing education and a nursing career we are faced with much criticism and need to be able to use that criticism to make our work better.ConstructivismOverview. Constructivism refers to learning as “an active, contextualized process of constructing knowledge through experiencing and reflecting on the experience rather than acquiring it” (Oermann, 2015, p. 20). Knowledge is developed from personal experiences and inferences drawn from the environment (Oermann, 2015). Contributors to this theory include John Dewey, Jean Piaget, David Kolb, and Roger Fry. Dewey’s idea of progressive education maintained that students need to be invested in what they are learning, whereas Piaget believed that that learning is a developmental process where knowledge is created rather than learned from a teacher (Oermann, 2015). Kolb and Fry advanced the Experiential Learning Model, which was composed of four key elements: concrete experience, observation and reflection of experiences, development of abstract concepts from reflections, and testing the new concept (Oermann, 2015). A cycle of learning is composed of these four elements that typically begins with concrete experience, although it can begin with any element (Oermann, 2015). Examples of teaching methods based on constructivism include case studies, class discussions, field trips, research projects, and simulation (Oermann, 2015).Strengths and weaknesses. Constructivism has both strengths and weaknesses. A weakness of this theory is that designing suitable activities requires careful planning, greatly increasing preparation time. Activities must tease out the required concepts, which makes learning the abstract difficult if examples are inadequate. Also, because lessons depend on specific answers to questions, lessons must be tested and tweaked just before presentation (Cooperstein & Kocevar-Weidinger, 2004). Although difficult and time consuming, constructivist learning has many benefits. Carefully planned, structured, and directed activities lead students to discover concepts and develop skills. Abstract concepts become meaningful, transferable, and retained since they are attached to the performance of activities. Ultimately, the activities lead to concepts where students have constructed the meanings and learning takes place (Cooperstein & Kocevar-Weidinger, 2004).?Brain-based LearningOverview. Brain-based learning (BBL) is the last major learning theory explicated in this paper. Although BBL may be described as “the active engagement of strategies based on principles derived from an understanding of the brain” (Jensen, 2008b, p. 4), it is most commonly recognized by three terms: engagement, strategies, and principles (Jensen, 2008a). This theory that emerged in the 1980s focuses on the brain’s chemical, biological, and physiological dynamics (Cardoza, 2011). According to BBL, as the brain’s cortical neurons increase the rate of signaling, more synapses are created in the areas of the brain that are stimulated (Oermann, 2015). Repeated firing and exposure to chemicals such as serotonin and adrenalin increase the number of neurons (Oermann, 2015). Ultimately, the number of neocortical areas engaged in the process are directly proportional to the longevity of learning that takes place (Sousa, 2011). Examples of teaching methods using brain-based learning include providing frequent feedback, encouraging peer support, allowing students time to practice prior to testing, maintaining a variety of teaching methods to support different learning styles, and preexposing learners to content prior to examinations (Oermann, 2015).A few primary contributors to the BBL theory include Jensen and Sousa (Oermann, 2015). Their work to disseminate neurological research helped uncover the role of brain chemistry in the acquisition of knowledge. The core principles of the BBL theory are delineated by two other contributors, Caine and Caine (1997), and include the following focuses: the brain is a uniquely organized parallel processor, stores information in multiple areas, and has many memory and neutral pathways; learning is a mind-body experience; the search for meaning is innate and comes through patterning; emotions drive our attention and are critical to patterning; learning involves focused attention; memory may be rote or spatial, but natural spatial memory is best for understanding; complex learning is constrained by stress and enhanced by challenge; and learning is developmental (as cited in Wilson, 2013). The BBL theory additionally incorporates several learning concepts, which include experiential learning, cooperative learning, practical simulations, learning styles, and problem-based learning (Wilson, 2013). Strengths and weaknesses. The strengths from utilizing these core principles and learning concepts in nursing education include the promotion of learning in accordance with the way the brain is naturally designed to work (Degen, 2014), instruction that can conform to a variety of types of learners, active participation of students in the learning process, increased retention of information (Jensen, 2008b), better insights into learning behavior, and the application of critical thinking (Cardoza, 2011). Contrarily, some weaknesses of BBL include time-intensive projects, an increase cost with hands on activities (i.e., simulation labs), and greater educator participation that may not be feasible in all class environments (McCarthy, 2010). Overall, many benefits are provided through BBL, however, more time-honored theories may be more appropriate depending on class size and time constraints.ConclusionsThe relevance of how six major learning theories can be applied in nursing education to benefit student learning outcomes were explored. Adapting learning theories to analyze how concepts can be shared and how students can best assimilate knowledge are important skills for all nurse educators to embrace. This paper provides an overview of some major theories that have helped shape our knowledge about learning and provides suggestions about how nursing faculty can teach students different ways to learn based on their personal needs.Behaviorism is one theory that looks at learning as trained or learned behaviors that are augmented by positive or negative reinforcements. Oermann (2013) discusses how behaviorism is being used in nursing education in traditional methods, such as lecture without active discussion and skills exercises. Cognitive learning focuses on learning as purely an internal process. Oermann (2013) points out that this differs from behaviorism, since learning must occur internally before a behavior change is noted. One extension of cognitivism is social cognitivism. Social cognitivism builds upon learning as an internal process, but is also affected by social interactions and the learner’s environment and cultural influences. Some examples of using cognitivism and social cognitivism in teaching are role modeling, observation, and demonstration (Oermann, 2013). The humanistic method of learning focuses on Maslow’s Hierarchy of Needs and learning as a person achieving his or her highest potential. Kleiman (2007) gives examples of the humanistic theory of learning and the value of the relationship between student, teacher, and patient as it develops through dialogue. Constructivism is a theory that is seen utilized in online courses. Online learning is being used more frequently for many undergraduate and graduate level students. Kala, Isaramalai, and Pohthong (2010) discuss the constructivism theory of e-learning based on the student’s interaction with their facilitators and their provided resources. In this method students build knowledge based on previous knowledge and experiences. Although a popular learning method, Kala et al. (2010) point out a few downfalls, such as lessons that are too structured and students with limited computer skills. Finally, brain-based learning is a method of teaching based on how the brain learns from a physiological perspective. Oermann (2013) discussed several teaching methods, including teaching in-depth concepts, early exposure of the learner to content, allowing student feedback, and using different teaching methods to address a variety of learning styles. Nursing educators need to familiarize themselves with all of these theories and how they can be used for teaching content to nursing students. Although each theory offers different advantages, teachers must consider their students’ personal learning demands. Learning is a complex process and each individual learns best in a variety of ways. Overall, knowledge of these theories can help the educator determine the most effective teaching method to employ in the classroom. ReferencesButts, J., & Rich, K. (2011). Philosophies and Theories for Advanced Nursing Practice. Sudbury, MA: Jones & Bartlett Learning.Cardoza, M. P. (2011). Neuroscience and simulation: An evolving theory of brain-based education. Clinical Simulation in Nursing, 7(6), e205-e208. doi:10.1016/j.eens.2011.08.004Cooperstein, S., & Kocevar-Weidinger, E. (2004). Beyond active learning: A constructivist approach to learning. Reference Services Review, 32(2). 141-148.Daly, M., Roberts, C., Kumar, K., & Perkins, D. (2013). Longitudinal integrated rural placements: a social learning systems perspective. Medical Education, 47(4), 352-361. doi:10.1111/medu.12097Degen, R. (2014). Brain-based learning: The neurological findings about the human brain that every teacher should know to be effective. Amity Global Business Review, 915-23.Halarie, E. (2005). Pragmatism and humanism in nursing education: A chance for change? ICUs & Nursing Web Journal, 24, 1-8. Jensen, E. P. (2008a). A fresh look at brain-based education. Phi Delta Kappan, 89(6), 408-417.Jensen, E. P. (2008b). Brain-based learning: The new paradigm of teaching (2nd ed.). Thousand Oaks, CA: Corwin Press.Kala, S., Isaramalai, S., & Pohthong, A. (2010). Electronic learning and constructivism: A model for nursing education. Nurse Education Today, 30(1), 61-66. doi:10.1016/j.nedt.2009.06.002Kleiman, S. (2007). Revitalizing the humanistic imperative in nursing education. Nursing Education Perspectives, 28(4), 209-213.McCarthy, A. (2010, April 11). Fundamentals of curriculum: Brain-based learning. [Web log comment]. Retrieved from Oermann, M. H. (2015). Teaching in nursing and the role of the educator: The complete guide to best practice in teaching, evaluation, and curriculum development. Danvers, MA: Springer Publishing Company.Rostami, K., & Khadjooi, K. (2010). The implications of behaviorism and humanism theories in medical education. Gastroenterology and Hepatology from Bed to Bench, 3(2). 65-70.Schunk, D. H. (2012). Learning theories: An educational perspective. Boston, MA: Pearson.Sousa, D. (2006). How the brain learns (3rd ed.). Thousand Oaks, CA: Corwin Press.Wilson, L. O. (2014). The second principle. 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