63CHAPTER 4

Learning Theories Applied to Curriculum Development

Coleen Saylor

OBJECTIVES

Upon completion of Chapter 4, the reader will be able to:

OVERVIEW

Educators who revise and develop a curriculum deal with many difficult questions. How can the program balance expectations between ideal and practical considerations? How can philosophical beliefs be congruent throughout the curriculum? Which instructional strategies are most relevant for these particular learners? How much flexibility should be included? Selecting relevant content, appropriate clinical placements, the difficulty level of assignments, and budget and time constraints provide even further critical issues.

As curriculum planners wrestle with these and many other concerns, a conceptual or theoretical foundation for learning provides a consistent rationale for their decisions, particularly those about instructional strategies (Dennick, 2012). That is, learning theories and concepts provide explanations of how learners learn and how educators can facilitate the best educational outcomes. Each of these approaches to learning suggests applications in the form of teaching and learning strategies that can be emphasized in the curriculum. Just as clinical nursing 64actions may be based on an understanding of physiological and pharmacological principles, for example, so learning strategies are based on principles or concepts of how people learn. Nurses are expected to provide rationale for their actions, and similarly, educators rely on learning theory and principles as rationale for curriculum decisions. The choice of assumptions of how learners learn also guides the consistency among course objectives, assessment and evaluation strategies, and program outcomes.

An essential part of the curriculum development process is a discussion among the curriculum planners of their perspectives about how learning occurs. As educators with varied backgrounds and experiences, curriculum planners bring a range of viewpoints about the best way for a curriculum to facilitate learning. In addition, nurse educators and students span the generations and embrace different worldviews and philosophical beliefs (Hunt, 2013). In order to produce the best curriculum for a particular program, its faculty, and learners, educators consider assumptions and beliefs, discuss previous experiences, and identify the appropriate explanations for learning, as they are relevant to the program under revision.

This collegial discussion, although sometimes difficult, provides a unique opportunity for learning as educators describe why a particular theoretical perspective is appropriate or not, in their view. The inclination to jump quickly to choose teaching strategies should be resisted as it would cut short this process of using a theoretical foundation as rationale for the later decisions.

The choice of relevant perspective about how learning occurs guides the consistency among goals, course objectives, assessment, and evaluation. Learning outcomes demonstrate whether or not the goals and objectives have been met, and provide feedback on the educational processes. In addition, the graduates’ professional performance provides critical measurement of the educational program.

An underlying philosophy of one perspective, constructivism, guided a curriculum redesign by emphasizing aspects of that perspective: inclusion of all faculty, promotion of cognitive apprenticeships, and strengthening communities of practice during the redesign process. These priorities were also demonstrated in learning objectives, strategies, and outcomes (Hagler, White, & Morris, 2011).

In addition to the differences among educators, professional literature does not provide consistent categories of theories, concepts, models, or principles relevant to nursing programs. For example, the constructivist perspective may or may not be included, or it may be seen as a subcategory of the cognitive theory, also called social constructivism. Gardner’s (1983) view of multiple intelligences is sometimes included as a distinct theory. Humanism may be called a theory or an educational framework (Braungart, Braungart, & Gramet, 2014; Candela, 2012). The various educational theories contain related ideas, concepts, and frameworks from psychology, sociology, and neuroscience (Dennick, 2012). A discussion of what defines a theory versus a principle or concept is beyond the scope of this chapter. However, the inconsistent list and variety of theories provide even further confusion for educators and clinicians attempting to base program strategies on a theoretical foundation.

Without attempting to rank or rate the myriad educational models, concepts, principles, and theories, this chapter includes six perspectives and two related concepts that are commonly used and have proved useful in academic and health care 65settings. Although there is inconsistency among these perspectives, educators recognize the importance of learning theory. In addition to the inconsistency of the models, they may be used in combinations. Many times, educators use combinations of theories according to diverse learner needs and the topic under study. In any case, educators are encouraged to examine their beliefs and knowledge about how people learn to provide an appropriate theoretical foundation for the learning strategies within their program.

This chapter reviews learning theories from the behaviorist, social cognitive, cognitivist, constructivist, adult, and humanistic perspectives. In addition, the concepts of metacognition and transformative learning are included within the cognitive perspective.

Learning is defined in this chapter as a “change in behavior (knowledge, attitudes, and/or skills) that can be observed or measured and that occurs … as a result of exposure to environmental stimuli” (Bastable & Alt, 2014, p. 14). Changes caused by maturation, such as growing taller, do not qualify. Temporary changes from fatigue or drugs do not qualify.

The learning paradigm shifted its emphasis over time from teacher to learner. The earlier instructional paradigm describes the faculty as giving out knowledge and students as passive recipients (filling the empty vessel). In contrast, the contemporary learning paradigm emphasizes the learner, while faculties are responsible for creating the learning experiences. Most importantly, the outcomes of the learning experience are of primary importance (Candela, 2012).

A learning theory is defined as a “coherent framework of integrated constructs and principles that describe, explain or predict how people learn” (Braungart et al., 2014, p. 65). Learning theories and concepts have much to offer in the practice of health care and nursing education, whether used alone or in combination. In the real world of complex clinical sites and busy classrooms, educators draw from a variety of learning theories for the teaching strategies that are appropriate for a particular course, learner, and content. Educators may utilize a variety of approaches to learning due to diversity in learners (Hunt, 2013). Although everyone has favorite theoretical approaches, many of them have the potential to contribute strategies to teaching and learning situations.

Rewards and reinforcement (behaviorism), role modeling (social cognitive), organization of content (cognitivism), the unique perspective of the learner (constructivism), and positive regard for students (humanism) all have important benefits. An educator can use strategies from several theoretical models at the same time. For simplicity, this chapter discusses each learning paradigm separately, but remember that the boundaries between theoretical paradigms are somewhat artificial. Further, as stated earlier, within and between each paradigm there is often controversy and disagreement, and newer researchers may argue for a different point of view, all of which are outside of the scope of this discussion.

Finally, in no way does this overview take the place of a more thorough understanding of the many researchers and schools of thought that have contributed to knowledge of how people learn and how educators can utilize those theoretical understandings for improved learning outcomes. There are many print and electronic resources available for further study in each of these paradigms and others that not included here.

66BEHAVIORIST LEARNING THEORY

Behaviorism is a group of learning theories, often referred to as stimulus–response, that view learning as the result of the stimulus conditions and the responses (behaviors) that follow. Behaviorism is primarily concerned with observable and measurable associations made by the learner (Hunt, 2013). Early work associated behavior with response to rewards and reinforcement. Although there are differences among the behaviorists, they generally view learning as the result of the stimulus conditions and the responses (behaviors) that follow, essentially ignoring what goes on inside the learner. For this reason, the theories are often referred to as stimulus-response or behavioristic (Braungart et al., 2014; Candela, 2012). This perspective asserts that behaviors, rather than thoughts or emotions, are the focus of study since behavior is affected by its consequences. To change people’s responses, this perspective changes either the environmental stimulus conditions or what happens after the response occurs. Currently behavioral educational perspectives are more likely to be used in combination with other learning theories, especially cognitive theory, instead of being used alone; and they are an effective adjunct to these other points of view about learning.

Behaviorist principles have been widely incorporated into nursing education and education in general, due to the work since the 1950s of widely acknowledged educators (Candela, 2012). Tyler (1949) addressed the learning setting; Bloom, Englehart, Furst, Hill, and Krathwohl (1956) developed a taxonomy of the cognitive domain, and Mager (1962) developed a model for writing behavioral objectives. Educators should not shy away from these classic books that provide the history of much that is current in nursing education.

CLASSICAL CONDITIONING

Respondent conditioning, also called classical or Pavlovian conditioning, emphasizes the stimulus and associations made with it in the learning process, depending on associations that are often unconscious. In this model, prior to the conditioning (learning), a neutral stimulus, with no particular value to the learner, is paired with a naturally occurring unlearned (unconditioned) stimulus leading to the elicited (unconditioned) response. Ivan Pavlov, the Russian physiologist, noticed that the dogs in his lab began to salivate before their feeding when they saw the keeper or heard his feet, and before they could see or smell the food. To explain this, Pavlov’s following experiment paired a bell, a neutral stimulus that would not ordinarily lead to salivation, with the dog food, the unconditioned stimulus that led to salivation, which is the unconditioned response. If repeated enough, the bell alone began to elicit salivation, showing that conditioning (learning) had occurred. After conditioning, the bell was the conditioned stimulus; salivation in response to the bell was the conditioned response (Braungart et al., 2014; Candela, 2012). Those with well-trained dogs have many examples of this type of conditioning.

Classical conditioning, especially of emotional reactions, occurs in all schools mostly through unconscious processes in which students come to like or dislike school, subjects, and teachers. A particular school subject is neutral, evoking little 67emotional response in the beginning. But the teacher, the classroom, or some other stimulus in the environment that is repeatedly associated with the subject can become a conditioned stimulus (Braungart et al., 2014).

One of the processes in classical conditioning is generalization, that is, a conditioned response that spreads to similar situations. After Pavlov’s dogs learned to salivate to one particular sound, they would also salivate after hearing other higher or lower sounds. The conditioned response of salivating generalized or spread to similar situations (Braungart et al., 2014). These findings have implications for teachers and all educational settings. Students with previous unpleasant or embarrassing educational experiences may well be reminded of them in a new classroom.

OPERANT CONDITIONING

Within behaviorism, operant conditioning is a second, much larger and more important, class of behavior. In classical conditioning, responses are brought about by a stimulus and could become conditioned to other stimuli. But the principles of classical conditioning account for only a small portion of learned behaviors (Braungart et al., 2014). These responses are elicited responses and the behavior respondent because they occur in response to a stimulus. The second class of behaviors is not elicited by any known stimuli, but they are simply emitted responses. These classical conditioning responses are called operants because they are operations performed by the individual. In the case of respondent behavior, the person is reacting to the environment, whereas in operant behavior the person acts on the environment. Another distinction is that respondent behaviors are largely involuntary, while operants are voluntary (Woolfolk, 2010). Operant conditioning is rewarding a desired behavior or random act to strengthen the likelihood of it being repeated. Praise and encourage patients’ efforts to ambulate the first time after surgery; rewarding that behavior will improve the chances that it will continue (Braungart et al., 2014). Similarly, teachers’ positive responses can reinforce students’ attempts to answer tough critical thinking questions.

REINFORCEMENT AND PUNISHMENT

Reinforcement is commonly understood to mean reward, but in this case it means any consequence that strengthens the behavior it follows. Whenever a behavior persists or increases, one can assume that its effects are reinforcing for the individual involved. However, individuals vary greatly in their perceptions of whether consequences are rewards or not. Students who repeatedly misbehave may be indicating that the consequence is reinforcing, even if it hardly seems desirable to another (Braungart et al., 2014; Woolfolk, 2010). Positive reinforcement is a (usually) pleasant stimulus presented following a particular behavior, such as a good grade or praise for an excellent project. However, inappropriate behavior can also be positively reinforced if, for example, an inappropriate student comment elicits laughter in the classroom. Negative reinforcement involves the removal of an unpleasant stimulus. If a behavior allows a student to avoid something unpleasant, that is a negative reinforcement. A common example is the car seatbelt buzzer. 68As soon as the seatbelt is buckled, the annoying noise stops. Both types of reinforcement strengthen behavior (Woolfolk, 2010).

In contrast to reinforcement, punishment decreases or suppresses behavior; therefore, behavior followed by a punishment is less likely to be repeated. In presentation punishment, the appearance of the stimulus following the behavior suppresses or decreases that behavior. Extra work assigned following unacceptable classroom work is an example. In contrast, removal punishment removes a stimulus following the behavior in question. Taking away privileges after inappropriate behavior decreases the likelihood of that particular behavior (Braungart et al., 2014; Woolfolk, 2010).

Instructional implications of the work on reinforcement focus on the belief that learning results from correct responses being rewarded. Therefore, schools and teachers should provide many opportunities for the desired responses and subsequent reinforcements. Students respond to satisfying experiences. Generally, rewards include teacher attitudes, acknowledgement of good questions, praise of work well done, grading policies that reward effort and excellence fairly, flexibility in assignments, a safe classroom emotional climate, regard for the students and their goals (Braungart et al., 2014), and positive comments on returned papers in any color of ink besides red.

Behaviorist perspectives recommend that teachers be sensitive to this phenomenon and minimize the unpleasant aspects of their courses, the subjects, and of being a student as much as possible (Woolfolk, 2010). Increasing the number of parking facilities may not be possible, but the teacher’s awareness of student inconveniences goes a long way in establishing a more positive experience. Look carefully for assignments seen as “busywork,” as each assignment that requires student time and effort should have a clear purpose in meeting the course objectives.

In addition to reinforcement, contracts and behavior modification provide common behaviorist techniques. Contracts can be used to change specific behaviors such as not completing an independent project or meeting clinical assignments. The contract is mutually agreed upon and signed by all relevant parties. Behavior modification is simply changing the consequences of behavior by applying positive rewards systematically in order to improve performance. Reinforcement of the behavior pattern then continues until the student establishes a pattern of success, at which time the reinforcement is gradually decreased and stopped. In contrast, ignoring an undesirable behavior tends to lead to extinction, according to this perspective (Braungart et al., 2014).

Behaviorism is relatively easy to understand and can be effectively utilized with other learning paradigms. However, some criticisms include this being a mechanistic, teacher-centered model in which learners are considered to be passive and easily manipulated. Complex mental processes, such as critical thinking are not emphasized in this perspective. Further, the rewards are usually external ones rather than promoting intrinsic satisfaction (Candela, 2012).

SOCIAL COGNITIVE THEORY/SOCIAL LEARNING THEORY

Social cognitive theory emphasizes the importance of observing and modeling the behaviors, attitudes, and emotional responses of others. This theory is largely attributed to Bandura (1986), who described how learning takes place with consideration 69of personal learner characteristics, behavior patterns, and the social environment. Over time, Bandura changed the name of his theory from social learning to social cognitive to distance it from the social learning theories of that time, and to emphasize the importance of cognition in people’s behavior (Boston University School of Public Health, 2013; Braungart et al., 2014). This chapter does not differentiate between social learning and social cognitive theory and, for simplicity, uses the term social cognitive theory.

According to the social cognitive theory, people are not driven by inner forces nor controlled by external stimuli. Rather, human functioning is explained in terms of interaction among cognitive, behavioral, and environmental influences, and it stresses the idea that much learning occurs in a social environment. People learn rules, skills, beliefs, attitudes, and strategies by observation. They learn from models and act in accordance with beliefs about their skills and the possible result of their behaviors (Burke & Mancuso, 2012).

Initially, behaviorist features and the imitation of role models were emphasized in this explanation for learning. In some texts, the earlier social learning theory was included within the behaviorist category, as it was based partially on behaviorist principles of reinforcement. In later constructions, however, the focus was on attributes of the self and internal processing. More recently, the theory focused on social factors and the social context for learning, but it clearly encompasses both cognitive and behavioral frameworks. The self-regulation and control that the learner exercises are considered more critical and more reflective of cognitive principles (Braungart et al., 2014; Burke & Mancuso, 2012).

This theory and its evolution emphasize the agency of the learner, and therefore, it is important to understand what learners perceive and interpret. This perspective views people as able to organize and reflect on their behavior, and therefore, regulate themselves, rather than simply reacting to environmental forces. The model emphasizes intentionality, self-regulation, self-efficacy, and self-evaluation in the learning process (Purzer, 2011). Learners can make things happen by their actions because they possess a measure of control over their thoughts, feelings, and actions. Thus individuals are both products of and producers of their own environments (Braungart et al., 2014).

With the three essential components of this theory, personal factors, behavior, and environmental influence, teachers can influence learning by strategies focused on any or all of these. They can work to improve students’ self-beliefs and habits of thinking (personal factors), improve academic skills and self-regulatory practices (behavior), and change the classroom procedures that might encourage student success (environmental factors) (Bandura, 1986; Burke & Mancuso, 2012).

SELF-EFFICACY

One of the most useful constructs of Bandura’s theoretical work is the concept of self-efficacy. Perceived self-efficacy is defined as “people’s judgments of their capabilities to organize and execute courses of action required to attain designated types of performances” (Bandura, 1986, p. 391). Research shows that beliefs about one’s self-efficacy influence persistence, effort, and choice of tasks, all of which influence 70behavior. This concept is particularly important in academic settings, because progress toward the desired goal and positive feedback from teachers and peers both influence the perception of self-efficacy, further raising persistence and effort (Purzer, 2011; Townsend & Scanlan, 2011).

A strong sense of efficacy enhances individual accomplishment and personal well-being in many instances. People who realistically believe that they will be successful sustain their efforts and quickly recover their sense of efficacy after setbacks, since they assume that failure can be corrected with more effort or acquired skills or knowledge. This high self-efficacy approach of individuals produces more successful outcomes and reduces stress (Bandura, 1986).

Beliefs about one’s efficacy are developed through four main sources. Mastery experiences are the most effective source of beliefs in one’s capabilities, as success builds a strong belief that one can be successful in the future. Experiences in overcoming obstacles through sustained effort, perhaps after setbacks, serve to create a strong sense of self-efficacy (Townsend & Scanlan, 2011; Woolfolk, 2010).

The second source of self-beliefs of efficacy is through the vicarious experiences of others. Seeing similar others succeed by sustained effort increases beliefs that an individual is able to master similar activities. Persuasion by a realistic and authentic person, perhaps a teacher or peer, is a third source of efficacy. As a result, an individual may exert greater effort and persistence than they would have otherwise (Purzer, 2011; Townsend & Scanlan, 2011).

The fourth source of self-beliefs of efficacy is the perception of stressful bodily and emotional states. Students with a lower sense of self-efficacy may consider a stress reaction a predictor of poor academic performance. In contrast, those with higher self-efficacy beliefs may interpret the stress as an energizing facilitator of performance. “Butterflies” in the stomach can be interpreted as a sign that one has a lot of energy and will give a good oral performance in class, rather than a sign that one will fail. A growing body of evidence suggests that self-efficacy is important not only in educational pursuits, but also in other human accomplishments. Ordinary social realities are filled with problems, adversities, and setbacks, and a strong sense of self-efficacy helps to sustain efforts to succeed, as long as the sense of one’s abilities is accurate and not overestimated (Bandura, 1986).

ROLE MODELING

People learn not only from their own experience, but also by observing others; therefore, modeling is a critical component of this theory. Role modeling refers to behavioral, cognitive, and affective changes resulting from observation of others. Thus, learning is often a social process, and significant people provide examples or role models for how to think, feel, and act. Bandura (1986) believed that social learning occurs principally by imitation. This type of learning is considered to be one of the important capabilities of the human species and includes the following steps (Braungart et al., 2014).

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