SAN ISIDRO COLLEGE

City of Malaybalay

Tel. No. 088-813-5541

Website: sic.edu.ph
Webmail: info@sic.edu.ph

NCM 102 N Health Education Mr. Rolando Y. Casas

Course Code Course Title Name of Instructor

I. Learning Module 2 : Applying Learning Principles and Theories to

Healthcare Practice

II. Introduction:

What is learning?
Learning is a relatively permanent change in mental processing, emotional functioning and/or
behavior as a result of experience (Bastable, 2003). Learning is a lasting or permanent change in
behavior as a result of experience which is primarily determined or influenced by the environment
where the person is situated. It is a complex process in mental processing, development of
emotional functioning and social transactional skills which develop and evolve from birth to death.

How does learning occur?

Learning occurs as the individual interacts with his/her environment and incorporates or applies new
information or experience to what he/she already knows or has learned. Learners also have their
own way of taking in and processing information (learning styles) and the type, nature and level of
motivation also affects learning.

III. Intended Learning Outcomes

At the end of the lesson, the students are expected to:

● Apply related principles of physical, social, natural and health sciences and humanities in conducting
health education in various settings.

IV. Stimulating Recall

During the previous lesson, we discussed the concepts of health and wellness. Health and wellness
are two concepts which have been used interchangeably as being synonymous to “living life with energy,
meaning and fulfillment”. But there is really a difference. On one hand, wellness is a person’s state of
mind or perception which allows one to reach his/her potential to the maximum and be able to engage in
healthy behaviors in order to live a full and healthy life. On the other hand, the contemporary definition of
health is based on the concept of “optimum level of functioning” of individuals, families, and communities.
Unlike wellness, one’s health is affected by several factors in the ecosystem which makes attainment of
health difficult or even beyond the control of the individual.
The new lesson now deals with the tools of trade that an educator must possess namely the theories
and principles of teaching and learning. Knowing the learning needs of the students as well as their learning
styles is of primary importance in the planning, implementation and evaluation of health education
programs. To make learning interesting and enjoyable, the educator must know the appropriate strategies
and methods of teaching and be able to create what is called the “teachable” moment when the learner is
ready to learn.
The challenge is great but knowing the learner’s characteristics, their learning needs and learning
styles and what theories to apply will make the impossible possible.

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 V. Presentation of the Topic/Learning Material

COMMON PRINCIPLES OF LEARNING

There are ten (10) learning principles that can help motivate the learner (de Young, 2003). Among these
are:

a. Use several senses. When dealing with the question of how much people are able to retain what has
been learned. It has been shown that people retain
10% - of what they read
20%- of what they hear
30% - of what they see or watch
50%- of what they see and hear
70% - of what they say
90%- of what they say and do.
This is shown by the Learning Experience Cone below

Figure 2. The Experience Cone

This is the importance of the RLE (Related Learning Experiences) which nursing students undergo in the
Nursing Skills Laboratory where
● they are made to imitate the procedures that are demonstrated by the instructors (role-modeling) , and

● are graded according to the skills they exhibit and the degree of comprehension of the rationale behind
the steps in the procedures as they perform the return demonstration. It is expected that by imitating,
they would be able to retain 70% of the lesson.

By applying these skills and knowledge in the actual care of patients in the hospital, this would be further
reinforced by additional practice and review of the principles and procedures and the extra care and caution in
their application and performance resulting in 90% retention.

b. Actively involve the learners in the learning process. Use more interactive methods involving the
participation of the learners like role-playing, buzz sessions, Q & A format, case studies, small group
discussion, demonstration and return demonstration.

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 c. Provide an environment conducive to learning. Always consider the comfort and convenience of the
learner (room temperature, the chairs and seating arrangement or space, noise level, adequate acoustics
and sound system, and an environment that is clean, pleasant-smelling, and smoke and dust-free.
d. Assess the extent to which the learners are ready to learn. Readiness to learn is affected by factors
like emotional status (anxiety, fear and depression) and physical conditions (pain, visual or auditory
impairment, anesthesia, etc.)
e. Determine the relevance of the information. Anything that is perceived by the learner to be important
or useful will be easier to learn and retain.
f. Repeat the information. Continuous repetition of information over a period of time enhances learning;
applying the information to a different situation or rewording it and giving practical applications will
help in the learning process.
g. Generalize information. Cite applications of the information to a number of applications or situations.
Give examples which will illustrate or concretize the concept.
h. Make learning a pleasant experience. Give frequent encouragement, recognize accomplishments and
give positive feedback.
i. Begin with what is known; move toward the unknown. A pleasant and encouraging learning
experience is achieved if information is presented in an organized manner and with information that the
learner already knows or is familiar with.
j. Present information at an appropriate rate. This refers to the pace in which information is presented
to the learner…are you talking too fast so that the learner has a difficulty in catching up with what you
are saying or are you too slow because the learner is already knowledgeable about the topic you are
discussing?

What helps ensure that learning becomes relatively permanent?

⮚ By organizing the learning experience so that it becomes meaningful and pleasurable; and by
presenting the information at the learner’s pace to ensure effective and efficient processing of
information.
⮚ Practicing or rehearsing new information mentally or physically to retain and strengthen
learning;
⮚ Applying reinforcements through rewards or recognition.

⮚ Assessing or evaluating whether learning has taken place immediately after the experience or
some later point in time. An evaluation feedback can be used to revise, modify, revitalize or
revamp the learning experiences.

LEARNING THEORIES

A learning theory is a coherent framework and set of integrated constructs and principles that describe, explain
or predict how people learn, how learning occurs, and what motivates people to learn and change ( Bigge
&Shermis, 1992); Hilgard and Bower, 1996; Hill, 1990).

⮚ Learning theories put together concepts and prepositions to explain “why people learn and predict
under what circumstances they will learn”. (de Young, 2003)
⮚ There is no single theory that can be considered as the best answer to these questions. The definition of
learning generally depends on the perspective of the learning theory that is being used.

Contributions of Learning Theories

1. Learning theories have helped us understand the process of teaching and learning or how individuals
acquire knowledge and change the way they think, feel and behave.
2. In the practice of healthcare, these theories have helped the health professionals to employ sound
methods and rationales in their health education efforts involving and in carrying out continuing health
education and promotion programs.

As the persons grows and develop, two (2) major processes take place which are:
1. Learning - any relatively permanent change in behavior brought about through experience.
2. Maturation- bodily changes which are primarily a result of heredity or the traits that a person inherits
from his parents which are genetically determined.

The 5 major learning theories that are widely used in patient education and health care practice are

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 1. Behaviorist
2. Cognitive
3. Social Learning
4. Psychodynamic
5. Humanistic

I. BEHAVIORIST THEORIES OF LEARNING

John B. Watson is the proponent of the behaviorist theory which emphasizes the
importance of observable behavior in the study of human beings. He defined behavior as
muscle movement and it came to be associated with the Stimulus-Response
psychology. He postulated that behavior results from a series of conditioned reflexes
and that all emotions and thoughts are a product of behavior learned through
conditioning. (DeYoung, 2003).

⮚ Learning, then, is a result of the conditions or stimuli (S) in the environment and the learner’s
response (R) that follow. This is known as the S-R model of learning or Stimulus-Response
Theory

Behavioral Learning is based on respondent conditioning and operant conditioning procedures .

A.1 RESPONDENT CONDITIONING

1. Classical or Pavlovian conditioning

- A process which influences the acquisition of new responses to environmental
stimuli.
o A neutral stimulus (NS) elicits an unconditioned response (UCR) through
repeated pairings with an unconditioned stimulus (UCS). A neutral
stimulus (NS) is a stimulus that has no particular value, significance or
meaning to the teacher. When the NS is repeatedly paired wwith the unconditioned stimulus
(UCS)and the unconditional response (UCR), there comes a time when the NS, even without the
UCS, elicits the same UCR.
o
Example: Situational Illustration

- Cecilia Belle, a pretty and lively three-year old, accidentally touched the flame (NS) of the candle. She
felt intense pain (UCS) and quickly withdrew her hand(UCR). Two days later, the same experience
happened and part of her finger was burned. Consequently, the flame of the candle (NS) came to be
associated with the pain (UCS) that even in its absence, just the sight of the flame makes her withdraw
her hand. Hence, the neutral stimulus (NS) , which is the flame, has now become the conditioned
stimulus (CS) and the automatic withdrawal of her hand has become the learned response.
2. Systematic desensitization is another technique based on respondent conditioning which is
widely used in psychology and even in medicine to reduce fear and anxiety in the patient.
(Wolpe, 1982)

This is based on the principle that repeated and gradual exposure to fear-inducing stimuli under
relaxed and non-threatening circumstances will give the patient that sense of security that no
harm will come so that he or she no longer fears the stimulus.

This is also a stress-releasing strategy that is adapted to help preoperative patients,

rehabilitating drug addicts and tension headaches and photos, among others.

3. Stimulus generalization is the tendency to apply the other similar stimuli to what was initially
learned.
● Discrimination learning develops later when varied experiences eventually enable the
individual to differentiate among similar stimuli.
4. Spontaneous recovery is usually applied in relapse prevention programs (rpp) and may
explain why it is quite difficult to completely eliminate “ unhealthy habits and addictive
behaviors (alcoholism, drug abuse, smoking) which one may claim having successfully “ kicked
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 the habit” or extinguished it only to find out that it may recover or reappear any time, even
years later.

A.2 Operant Conditioning

- Developed by B.F. Skinner which focuses on the behavior of the organism and
the reinforcement that follows after the response. (Alberto & Troutman, 1990)

Reinforcements are events that strengthen response. It is one of the most powerful
tools or procedures used in teaching and is a major condition for most learning to take
place.

● A reinforce is a stimulus or event that is given, applied or elicited after a response to strengthen or
reinforce the possibility that the response will be repeated.
● When specific responses are reinforced on a proper schedule, the behaviors can be increased or
decreased.
Example: The child who is given positive reinforcement like a reward or praise every time he/she excels in
school will be encouraged or motivated to maintain this behavior.

Application to Healthcare/Implications of the Study

1. Praise may assist in the transfer of learning from one area to another.
2. Learning under the control of reward is usually preferable to learning under the control of punishment.

Ways of Employing Positive Reinforcement:

1. Verbal Ways
● Saying praise words or phrases like “good”, “well done” when the student responds

● Statements like “ That was a well-expressed opinion”. Or “I like the way you answered the question
of the patient’s mother” are moral boosters.
● Requesting the student to share his success story with his classmates. This gives recognition to the
student and increases the level of prestige with his classmates.

2. Non-verbal Ways
● Like nodding, smiling, looking, pleased, writing student’s comments on the board, and giving the
“thumbs up” sign especially where group work is concerned.
3. Citing in class or Publishing
● Posting on bulletin board exceptional works or outputs

Classification of Educational Reinforcers

1. Recognition – includes
▪ Praise, certification of accomplishments

▪ Formal, acknowledgements (awards, letters or recommendation, testimonials)

▪ Informal acknowledgements (private conversations, “pat on the back”)

2. Tangible rewards- Grades, food (free lunch), prizes, certificate of appreciation or citations

3. Learning activities- opportunity for desirable enrichment assignments like membership in “honors”
class, more interesting, or more difficult clinical assignments.
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 4. School responsibilities-
▪ Opportunities for increased self-management and more participation in decision making

▪ Acceptance of suggestions for improving the curriculum

▪ Greater opportunity for selecting own goals for learning experiences

▪ Greater opportunity to control your own schedule and set your own priorities.

5. Status Indicators
▪ Appointment as a peer tutor

▪ Having own space (study corner, desk)

6. Incentive feedback
▪ Increased knowledge of examination scores

▪ Knowledge of individual contributions (helping others)

7. Personal activities
▪ Opportunity to engage in special projects

▪ Extra time off

Note: Remember that reinforcement should be appropriate or directly linked to the learning tasks and student’s
accomplishment. Its indiscriminate use may result in happy students but no to productive students (Tosti and
Addison, 1979). Negative reinforcement is tantamount or synonymous to punishment. Behaviors may be
decreased through;

▪ Nonreinforcement by ignoring the behavior (whether it is desirable or undesirable)

▪ Or applying punishment immediately after the response and must be consistent and the highest
“reasonable level”. Cardinal rule of Operant conditioning is to punish the behavior, not the person.

VI. Activities/Exercises

What Have I Learned So Far?

1. How do you define the concept of learning?

2. How do you typically enhance your retention or recall of studied material? Could you share a personal
experience that has proven effective in helping you remember what you've learned?

3. What significance lies in learners actively participating in the learning process?

4. What, in your opinion, makes for an ideal classroom environment, and why is it important to create a
conducive atmosphere for learning?

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5. How can we ensure that learning becomes relatively permanent or lasting?

6. What is behaviorist theory all about?

7. Cite a practical situation that illustrates

a. Classical conditioning
b. Operant Conditioning

8. In your view, what are the benefits of using positive reinforcement with students or learners?

9. Do you believe that offering acknowledgment and tangible rewards enhances motivation to perform
better?

10. Say something about this statement: “Cardinal rule of Operant conditioning is to punish the behavior,
not the person.”