With reference to the Nursing and Midwifery Council (NMC, 2015), learning is a professional responsibility. This relates to the idea that the ability to learn and apply knowledge to practice ensures competence and attitude for lifelong learning which are central to the delivering of effective clinical and patient care. Learning is the process of acquiring new or modifying existing behaviour, knowledge, values, attitudes, skills, strategies, beliefs or preferences (Gross, 2010). Learning theories attempts to provide explanations about learning and their application to different learning situations. As a student nurse, knowing the different learning theories and personal learning styles will help me to make sense of the principles underpinning knowledge acquisition as well as guide my values, skills and strategies required to not only attain success in my nursing education but also manage my professional development effectively.
Learning theory provide the framework for interpreting how individuals acquire, absorb, process, retain and recall knowledge (Schunk, 2012). Over the years, researchers and psychologists have examined learning from different viewpoints and their findings have led to different theories and complimentary strategies, which can be used as a guide to promote learning. In particular, learning theories are useful in the current health structure where health professionals are required to show the regular use of theories and clear reasoning in interactions with patients, management and continuing education. Apart from the profession, knowledge about the learning process is largely associated with the everyday life of individuals. Learning theories can be used individually, or in a group, not only for understanding and learning new things, but also for problem solving, constructive communication and behaviour development (Quinn, 2007).
There are many different learning theories; however, this essay will focus on the behaviourism, cognitive psychology, social learning theory, constructivism theories and experiential learning.
The behavioural theory believed that learning is a change in observable behaviour and it happens through associations between a stimuli and a response with external factor. Behaviourism assumed that knowledge exists independently outside consciousness and as such, the learner is viewed as passive (Schunk, 2012).
The key contributors to this theory include, Pavlov, Bruner and Skinner. The operant conditioning model by Skinner (1976) contended that a response to a stimulus is more likely to occur in the future as a function of the consequences of prior response. Accordingly, positive or negative reinforcement can be used to encourage the repetition of the desired behaviour and to reach the learning goals.
The significance of this theory to nursing is to guide and shape clinical skill performance. For example, the learner can build on specific skills through trial and error to attain the desired skills. Satisfying results will lead to its strengthening and unpleasant results will encourage the students to find alternative method until the desired goal is reached. That said, behaviourism does not prepare learner for problem solving or creative thinking. Learners only do as commanded in form of a response to stimuli and as such, taking initiative to change or improve things will rely on the learner’s motivation (Quinn, 2007).
Unlike behaviourism, cognitive psychology believed that learning is an internal process. This is based on the idea that humans process the information they received rather than merely responding to stimuli. (Atkinson, 1968) They viewed the learner as information processor and focused on how the human mind handles information including attention, language, memory, thinking, problem solving and consciousness.(Craik, 1972). Cognitivists argued that with effective cognitive processes, learning is easier and new information can be stored in the memory for a long time. On the other hand, ineffective cognitive processes result in learning difficulties that can be seen anytime during the lifetime of an individual.
In my view, the main aspect of this theory for nursing is that it equips the learner with questioning skills and problem solving, so by exploration and information processing the learner will be able to learn actively, solving and searching for new information, and reviewing their previous experiences for better understanding. More importantly, it can be used for identifying appropriate nursing care. For example, linking concepts to understand and solve problems, structure or goal setting (organising ones learning or tasks in efficient and meaningful way), and critical thinking (analyse and relate patient problems to physiology).
Social learning theory proposed by Bandura (1977) is viewed as a bridge between behaviourism and cognitivism learning theories as it considered thought processes and the role it plays in deciding if behaviour is to be imitated. According the theory, learning can occur by watching and observing the actions of others. From observing others, one forms an idea of how new behaviours are performed, and on later occasion this observed and internalised information serves as a guide for action. (Fryling (2011)
The benefit of role modelling theory is that it offers learners the opportunity to work with experienced and knowledgeable practitioners (Spouse, 1998). For a student nurse, it offers opportunity to learn the professional role by observing professional nursing practices. Through this, student not only observes the performance of the nurses, but also the interactions between nurses, patient and other caring team members. Thus, their attitudes are formed regarding the practice, skills and techniques as well as patient care. The role of the instructor as a model is very important for the learners, not only for performing the procedures, but also for teaching the way of communication with patients and medical team partners and compliance with ethical principles, as well (Spieglar 2009).
Constructivism theory is broad and founded on the premise that individuals construct own perspective of the world based on their experiences and internal knowledge. They believed that learning is unique and different for each person; based on how the individual interprets and creates the meaning of his or her own experiences. According to Piaget….), learning is a process of active discovery where learners create their own subjective representations of objective reality. He contended that the role of the instructor is to recognise the knowledge that the learner currently possess and facilitate discovery by guiding learners as they attempt to adapt new knowledge and modify the old to accommodate the new.
The main aspect of this theory is that it helps learners with moral development and how to apply knowledge in different settings. However, the learner may need a significant base of knowledge upon which to interpret and create ideas. Additionally, outcome may not be predictable as learners construct their own knowledge. Thus, constructivism may be less effective the result is expected to be consistent.
In similar fashion, Vygotsky (1978) posited that learning is a collaborative process and a product of social interactions. From his standpoint, learning is not only the assimilation and accommodation of new knowledge by learners, but also, the process by which learners are integrated into a knowledge community. This model highlighted the role of language and culture in cognitive development and offered them as the frameworks through which human experience, communicate, and understand reality. Vygostsky accept that knowledge is actively constructed by the learner as proposed by Piaget. However, he argued that learning also depend on the learner’s internal drive to understand and promote the learning process.
The significance of this learning approach is that it helps the learner to develop valuable skills such as teamwork skills, collaborative working, brainstorming, questioning, summarising, clarifying, predicting, evidence based practice, research project, social negotiation and relating individual learning to the success of group learning. Quinn (2007) contended that working in groups can strengthen the weak persons through working with others.
Experiential learning model is centred on adult learning to understand the manners in which experiences motivate learners and promote learning. The key proponent in this theory is Kolb (1984) who defined learning as the process whereby knowledge is created through the transformation of experience. In his view, learning is a holistic set of processes that are continuous, with a lesser emphasis on outcomes. He argued that effective learning takes place when a person progresses through a cycle of four stages; doing the tasks, reviewing and reflecting on that experience, learning from the experience and applying what you have learned into practice in future situations. Kolb also observed that learners naturally prefer certain learning style. He accepted that personal learning style can be affected by factors such as, social environment, educational experiences, or the basic cognitive structure of the individuals. In order to maximise personal learning, Kolb recommended that learning should be placed in a context that is relevant to each learner or else it is likely to be forgotten very quickly.
The significance of this theory is that it helps the learner to develop valuable skills that impact learning in both training and nursing practice. These skills include team building, collaborative working, problem solving, communication, performance, planning, reasoning, raising questions, researching and gathering information, interpreting, presenting arguments and evaluating.
Focusing on learning styles, Goldfinch and Hughes (2007) suggested that understanding personal learning styles supports the learner in appreciating the value of learning and thus, develop the skills needed to practice and strengthen self-confidence. There are many models for identifying individuals preferred learning styles; however, I will focus on the models by Flemming and Honey and Mumford.
Flemming (2001) postulated that people make use of all their senses when they gather information from the world around them including learning. He advance VARK model which he used to assess reliance on learning styles. He identified that some learners are visual, preferring images and written information, some are auditory and prefer listening, some prefer reading and writing, while others are kinaesthetic and feel comfortable with moving, touching and enjoy practical ‘hands on’ working. He developed a self-report inventory to select the answers that best match learners preferred approach to learning. He claimed that the model can help optimise learning experience by focusing on the method that provides the best outcome for individuals.
Honey and Munford (2006) proposed that learners can learn the strategies to optimise their learning and potential for success if they become aware of their learning styles. Their learning style inventory identified four learning approach which have a close connection to Kolb’s four stages in his learning cycle. They suggested that a student’s learning style reflects his or her preference for the four stages of the adult learning cycle which include; having an experience (the activist stage), reviewing the experience (the reflector stage), concluding from the experience (the theorist stage), and planning the next steps (the pragmatist stage).
Honey and Munford also developed a Learning Style Questionnaire to help understand ones particular learning style. Having completed the questionnaire, my dominant learning style indicated theorist. My score was strong for both pragmatist and reflector as a learning preference and I scored low as activist. According to Honey and Munford, being a theorist mean that I learn most easily from activities where I have the chance to question and probe practice. I am stretched by analysing a complex situation by working with people who ask and search for similar answers. I adapt and assimilate observations into complex and logically sound theories; I also think problems through stage- by-stage and tend to be perfectionists who like to fit things into a clear structure. As a theorist, the activities that allow me to benefit from the learning process are situations where there is a chance to discover the association and the interrelationship between ideas, events and situations. On the flip side, I will struggle where there are activities without background information or apparent purpose which will impair my learning and where I feel myself out of tune with other participants.
Honey and Mumford (2006) advised that a pragmatist learner learns best through existing activities that allows role play or trial practice; providing the learner the opportunity to practice what they have learnt. In this case being a pragmatist enables me to take part in activities by effort to follow instructions from lectures, and colleagues. On a plus side, this enhances my self-confidence and also promotes self-regulation of clinical reasoning skills. However, it can be difficult for the learner in situations where the learner cannot see significant reward from the activities. In this case, it will be best for me as a student nurse to link theory to practice by asking questions to clarify points being made to develop my understanding.
Jasper (2003) expressed reflector as an individual who has the experiences of standing back and looking at a situation from different perspective. Having a high score as a reflector in the questionnaire, shows I will enjoy activities which involve watching, observing and listening to people during group discussion and lecturing session. There is also the tendency to think about what has happened or learnt by relating new ideas or information to the past experience and then to examine them (Howatson-Jones, 2010). Learning as a reflector will enable me as a student to be thoughtful and consider all possible areas and implications of obtaining detailed information before making decision (Honey and Mumford, 2006).
According to Alghasham (2012) learners predominantly possess different strengths of learning preferences; therefore being dominant in one area does not ultimately imply weakness in the other areas.
In conclusion, all these theories are important to understand when deciding which strategies to apply. However, it is important to consider level of knowledge, thought processing demand and desired outcome. Equally, learning style is beneficial for student nurses because it allows individuals to reflect on the past, present and future. It has also indicated my dominant learning style and helped me to identify my weaker style which has aided me to provide an action plan that will equip me to learn from a wide variety of experiences for me to be able to deliver good standard of care to patients now and in future.