Behavioral, cognitive, humanist approaches

Behavioral learning theorists believe that learning has occurred when you can see changes in behavior. The behavioral learning model learning is the result of conditioning. The basis of conditioning is that a reward following a desirable response acts as a reinforcer and increases the likelihood that the desirable response will be repeated. Reinforcement is the core of the behaviorist approach. Continuous reinforcement in every instance of desirable behavior is useful when a behavior is being introduced. Once a desired behavior is established, intermittent reinforcement maintains the behavior. Behaviorist theory approaches are frequently used in weight loss, smoking cessation, assertiveness training, and anxiety-reduction programs. The importance of regularly and consistently rewarding desired behavior immediately and not rewarding undesirable behavior is crucial to the success of a behaviorist approach to learning. Learning is broken down into small steps so that the person can be successful. The nurse provides reinforcement at each step of the process. For example, when a patient is learning how to inject insulin, the nurse looks for a positive behavior and then gives the patient immediate reinforcement by saying, „I liked the way you pulled back the syringe,“ or „You did an excellent job of withdrawing the insulin.“

Cognitive learning theorists believe that learning is an internal process in which information is integrated or internalized into one’s cognitive or intellectual structure. Learning occurs through internal processing of information. From the cognitive viewpoint, how new information is presented is important. In the first, or cognitive phase of learning, the patient learns the overall picture of what the task is and the sequences involved. In the second, or fixation learning phase, the learner begins to gain skill in performing the task. Whether a physical task is learned as a whole or part by part depends on its complexity. For example, learning how to take a blood pressure is a complex task. The patient must learn how to physically manipulate the blood pressure manometer, learn how to hear blood pressure sounds, and understand the meaning of the sounds. Each of these tasks can be practiced as a separate activity, then combined. In the last phase of learning, the automatic phase, the patient gains increasing confidence and competence in performing the task.

Humanist learning theorists view learning as a function of the whole person and believe that learning cannot take place unless both the cognitive and affective domains are involved. The individual’s capacity for self-determination is an important part of humanist theory. For example, humanist theory is used to help post myocardial infarction patients regain a sense of personal control over their health care management. It is possible to select elements of each theory that you find useful in patient teaching.

All patients grow with success and do better when achievements are recognized and reinforced. Respecting the whole person in a supportive environment can encourage learning. Learning is also fostered through structuring information appropriately and presenting it in meaningful segments with appropriate feedback.

Learning readiness