Introduction
The learning process involves generation of new knowledge that changes the way people understand and view the activities around them. This learning can be unplanned as in the case small children developing skills such as feeding themselves. Planned learning involves grown ups whereby people 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 experiences to compare with (Cooper , Smith & Upton 2002). Behavioural, cognitive, and adult learning theories have been a guide to clinical educators. They have enabled them to introduce and teach nursing students effectively. These theories have enabled them to introduce subjects, measure their progress, and get feedback on the 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 asses 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.
Theoretical Framework
This paper will discuss on 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. It is also applicable for practising 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 duration of time 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 early twentieth century. He showed how conditioning occurs by giving dogs food after the ring of a bell. This process was continued over time until the sound of the bell made the dogs salivate regardless of whether 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, First acquisition of knowledge in this case the sound of the bell means food is ready. Secondly 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 rang and no food was provided for some time. Thirdly, the stimulus becomes general such that further training is not necessary because a similar signal will still trigger response. After continued ringing of the bell and offering food, availability of food is not the only cause for salivation, simply ring the bell. And finally discrimination whereby a different signal other than the bell would not trigger any response (Pritchad 2009).
Thorndike’s research further explained the effect of behavioural change on learning. It indicates that the response triggered by an 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 the fresh students it requires that medical terms that will involve all areas of nursing are introduced. This according to Pavlov’s model is the acquisition stage. Conditioning stage occurs when these terms are used often in explaining different kinds of approaches to illnesses and procedures. With continued use of these medical terms and procedures, they become embedded in their minds. If this happens then they may become accustomed to nursing and may take further knowledge for granted. This can be compared to Pavlov’s generalisation stage, students assume that they are already informed and may lack interest in sharpening further this knowledge. This is a weakness for this model. Discrimination can be observed in cases where students may not be willing to research from other sources. They are likely to sole depend on the information provided by the teacher as Pavlov’s dogs would not register any other signal apart from the bell (Pritchad 2009 ).
To overcome these weaknesses in Pavlov’s model, Learning can be programmed by encouraging students to excel in their studies either through rewards or recognition of good students. For the weak students this can be helped by engaging them more unlike punishing which may make the performance worsen. Encouraging students to read more either through research assignments or term papers will reduce discrimination. It will help students explore this acquired knowledge further on their own .Through such researches and self initiated readings will make them more knowledgeable and competent in their studies. These extra activities justify Thorndike’s opinion that behavioural change can be altered positively to get better 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 the already existing knowledge. External factors are also conditions that affect learning. It is necessary that nursing instructors 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 Gesalt theorists who differed with behavioural theory by indicating that learning is not based on the single stimulus-response effect. According to them response is triggered by several factors which are real and can only be explained by the person who is experiencing learning. Unlike behavioural theory, external factors do not matter; personal insight and the knowledge required is what counts. Tolman suggested that people should learn as much as they can 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 in a real situation to measure their learning progress (Cornings & Barbara , 2005).
This theory concentrates on the brain as the determinant of the amount of information that can be absorbed. It stipulates that each individual understands 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 weakness in learning, then the learning process is simplified.
Nursing requires that students obtain theoretical knowledge as well as practical knowledge. As Gesalt theorists suggest, it is important that trainers provide all the theoretical knowledge a student requires. It is upon 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 is able to determine the kind of approach to give according to the student’s level of understanding. The trainer is able to link the unknown facts with the known facts so as to enable the student to improve the quality of their existing knowledge that 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 cognitive approach specializes on what is in the brain. When a student is practising a learnt theory, they do so by transferring what is in the mind to a realistic situation. The instructor assists the student through 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 determines whether a student will be able to 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. Procedures change, other forms of medicine administration introduced and in some cases some equipment discarded to use better modern ones.
Teaching adults is simpler as compared to children based on the assumption that they have an existing knowledge. However according to Merriam, adult students require motivation and this can be done by establishing a friendly atmosphere to encourage them to be more relaxed to learn. Showing concern and creating a rapport is also necessary to ensure that students are able to share any difficulties experienced (Merriam, 2008).
The good thing about adults is that they have a free will initiated by self to learn. These will is indirectly affected by the goals that they have set as well as the relevance of the study which is due to the applicability it has on their work. They do not learn solely for knowledge but to practice in their work as well (Cornings & Barbara G. 2005).
Adult learning theory is more focused on developing meanings from perspective. The students want to establish the relationship between their work and the concepts that are learnt (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 pedagogy view in which learners analyse situations as per their desire to fight existing injustices or oppressive actions in their field. Bigotry on the other hand is more practical and is applied on the working situation where great details are required so as to learn (Brookfield 2005). These two views when combined in instructing, instructors will be able to quench the students thirst for knowledge of the applicability of theories in their work experience.
Conclusion
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, it is important that nurses 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 are interested in advancing their knowledge. Such nurses are adults which require that trainers use the adult theory approach to be able to instruct effectively. If instructors integrate these theories, they are able to cater for both fresh students and experienced nurses. This ensures that nurses are competent in their profession and are able to move with the modern times.
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