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Learning Theories: The Basics to Learn in Medical Education

Article  in  International Journal of Applied and Basic Medical Research · December 2017

DOI: 10.4103/ijabmr.IJABMR_385_17

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Dinesh K Badyal Tejinder Singh

Christian Medical College & Hospital Adesh University Bathinda Punjab
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Editorial

Learning Theories: The Basics to Learn in Medical Education

The word “theory” is quite commonly used to represent or principles only that can be part of various theories but
the knowledge or cognitive component in our day‑to‑day are not the learning theories per se.
work. The various learning theories in the educational field
Let us have a look at the learning theories in brief.
indicate that it is more like a set of principles/ideas that
Behaviorism theory says that learning is a “change in
provide an explanation of working of a concept or basis
behavior in the desired direction” that happens due to using
of practical happenings or connections between various
various techniques like reward and encouragement for
principles in a model or working together. Its like the script
correct behavior; repetition, feedback and reinforcement for
of a movie, i.e., script like a theory provides an explanation
corrections needed in behavior so that corrections are done
of happenings and movie is like actual happenings. Hence,
and sustained. This is in response to an external stimulus.
movie director can ask questions like why I should make a
This is based on assumption that number of internal motives
movie on this script. The script should be able to explain
why things would work, what are various connections, cannot be measured hence behavior which is observable
even add some evidence to show that these things do work, can be studied. The system relies on continuous repetition
etc. and “skill and drill” exercise. This happens in small chunks
and builds up leading to change in behavior.[4,5]
Several theories have been proposed for learning. There
are number of concepts in learning which are essential The second theory, cognitivism theory represents internal
components for an understanding of these theories. cognitive restructuring due to changes in individual’s
Sometimes, there is confusion between concepts, principles, schemata (knowledge). The learner uses cognitive tools,
and theories. Most of us are familiar with adult learning such as insight, information processing, perceptions, and
principles or andragogy. It is also one of the issues most memory to facilitate learning. It involves acquiring, storing,
discussed as the theory behind adult learning. It looks like and retrieving information. The learner develops capacity
a theory based on the fact the discoverer put it forward as and skills for effective self‑directed learning. The teacher
a theory different from pedagogy. Hence, it was taken by facilitates the learner about “learn how to learn.”[6,7]
people easily as something different from pedagogy, i.e., a Constructivism theory explains how new understanding
different point of view for adult learning as compared to develops by building on individual’s existing understanding.
kids. However, if you rethink about how kids learn, they Learner constructs knowledge based on their experiences
also learn what is relevant. The learning topics for adults and that how they do so is related to their biological,
are always not so free choices, for example, in a medical physical, and mental stage of development. Learner
undergraduate class the students learn as a group based on assimilates, accommodates, and adapts knowledge to
a certain topic, here an individual student has no choice to develop new understanding. The learning process involves
learn something else but that topic only. Similarly, not all construction of meaning from experiences through critical
adult learners are equally intrinsically motivated, and this reflection.[5]
adds another gray area in adult learning.[1,2] The literature
says there is modest evidence that supports andragogy. Sociocultural theory assumes learning to be a social process
Adult learning is more like a concept/model but not where learning happens in a social context. The learner is
actually a learning theory. involved in apprenticeship in the community practice or as
a full member in the community. Learning is in relationship
Similarly, experiential learning and work‑based learning between people and environment. An increasing amount of
are more like concepts but not theories. In experiential medical education occurs in workplace contexts; hence,
learning, learning is based on experience. It says that there this learning theory can be an appropriate explanation in
is a concrete experience followed by reflection on it, then this setting.[1,5]
abstract conceptualization and further experimentation
or improvement.[3] This is again more of a model than a Critical theory explains how to change society to make it
theory. However, the learning never happens in the real equal for all by encouraging participation of all learners
world in such a straightforward manner. Hence, experiential especially those who are marginalized or oppressed.
learning does provide us different aspects of learning but Humanism theory says that learning is more related to
is not a theory per se. Interestingly, these principles (adult one’s own growth as a doctor and human being. During
learning, experiential, workplace‑based) do reflect some this learning, there are challenges like exploration of one’s
of the learning theories, for example, work place‑based emotions and changing identify of one’s self. The goal
learning has elements of sociocultural theory, experiential of this approach is for the learner to become autonomous
learning has elements of constructivism and humanism and self‑directed. Self‑directed learning is one of the most
theories. This fact again emphasizes that these are concepts important principles of this theory.[5]

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Badyal and Singh: Learning theories

There are a lot of similarities as well as differences between After discussing various learning theories, let us see how
these theories. In a way, they represent learning in context these can be used in various scenarios. In a clinical and
with stage of learner and situations. They complement each communication skills course, the behaviorism theory
other or are a part of evolutionary sequences in learning, for would be appropriate, as during this course the correct
example, as learner memories and understands (cognitivism) responses in performing skills can be learnt slowly over
he/she tries to build up connections between various time as students are being provided feedback, rewards
issues (constructivism), during this process learning is and encouragement by teachers. For clinical skills, their
influenced by context  (sociocultural), some behavioral response can be corrected in small chunks and repetitions
changes might have happened by this time (behaviorism). are provided so that they are eventually able to learn
This leads him/her to think about changes in society (critical) correct skills. Behaviorism emphasizes on the mastery of
and he/she might start thinking about one’s growth as doctor prerequisite steps before moving to subsequent steps; this
as a good human being (humanism). Even at these stages, learning orientation is aimed at reinforcing correct skills.
more behavioral changes might happen. In skills learning, teachers demonstrate specific desired
In almost all of these theories, learner is actively involved behaviors, learners observe the manner or technique in
and hence, this seems to be a common factor. Active which a desired skill or behavior should be performed, and
involvement may be reflected in various ways such as some scoring rubric (checklists, rating forms, and direct
trying to understand, discussing, processing information, observation) can be used to assess performance and provide
working in community, modulating feelings during reinforcement. This learning theory is most advantageous
learning, and during corrective actions. The last example, when a change in behavior is the desired outcome of an
i.e., corrective actions based on provided feedback is in educational intervention.
concern with behavior theory. Although it is mentioned For a basic science course, you can think of cognitivism
that learner is passive in behaviorism theory, it is difficult and constructivism theory. If basic sciences course which
to understand how the learner can be passive when he/she is more conventional and happens more in isolation from
is using feedback to correct their responses. The learner clinical sciences then cognitivism looks appropriate as
needs to be actively involved while correcting responses. they need to process and retrieve information, use new
Similarly, comprehending/understanding seems to be related knowledge, improve the schemata with new knowledge.
with all theories as without understanding it is very difficult This theory can facilitate the acquisition of knowledge and
to construct, and think about sociocultural issues and make the development of learning skills that are applicable in
justice in society and to change society for betterment. The other learning situations regardless of the topic or context.
cognition, i.e., knowledge component is involved in all
theories, however the extent and context is different. However, if the basic sciences course is dynamic and
involves the integration with clinical sciences the
Although there are overlaps in these theories, still they constructivism seems more appropriate as they need to
are individual characteristics in these theories which make apply this knowledge to clinical cases. The learner needs
them unique as single theories. The humanism theory is to understand the concepts in basic sciences and make
quite specific for thinking about emotions and one’s growth connections with its applicability in clinical sciences. There
as human being; critical theory is more inclined for justice should be development of construction of understanding
and equality in the society; learning through involvement the relevance of learning basic sciences.
in community is quite specific for socioculturalism theory.
For a community‑based education program sociocultural
The role of teacher also changes in these theories, theory would be better here as it provides apprenticeship
e.g., in behaviorism theory the teacher should have a good in the community and experience of working as part of
knowledge of subject and be active. Teacher arranges the community. The learning process can be viewed as an
appropriate learning environment to elicit correct responses. interaction with and observation of others in a social
In cognitivism theory, a teacher structures content of learning context. Physicians usually learn in the social context
activity. In constructivism theory, teacher acts more like a by observing each other’s techniques and behaviors.
facilitator and guides the learning of the students. Therefore, The learner can role model the good health providers
the behaviorism theory is teacher‑centered; cognitivism, and rehearse it and do it when situation demands. The
humanism, and constructivism theory are learner‑centered. unique aspects of this learning theory combine role
These theories can provide rational basis for the selection modeling behavior with cognitive learning to deepen
of specific teaching‑learning methods/strategies, framing the learner’s understanding of how, why and for what
learning objectives, and select/design evaluation strategies. purpose the role model performs a specific task in a
Remember that learners have different interests, different certain way. The teacher is responsible for modeling
learning preferences, and different backgrounds. Integrate new roles, guiding behaviors, and providing learners
various positive aspects of these theories in the classroom with opportunities to practice these new roles and
environment to optimize learning. behaviors.

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Badyal and Singh: Learning theories

Dinesh K Badyal1,2,3, Tejinder Singh2,3,4 cognitive perspective. New Horiz Adult Educ Hum Resour Dev
2006;20:38‑49.
Departments of Pharmacology, Pediatrics, CMCL-FAIMER Regional
1 4 2

Institute, 3MCI Nodal Centre, Christian Medical College and Hospital, 7. Patel VL, Yoskowitz NA, Arocha JF. Towards effective
Ludhiana, Punjab, India evaluation and reform in medical education: A cognitive and
learning sciences perspective. Adv Health Sci Educ Theory Pract
Address for correspondence: 2009;14:791‑812.
Dr. Dinesh K Badyal,
Professor and Head, Department of Pharmacology, Christian Medical
College and Hospital, Ludhiana ‑ 141 008, Punjab, India. This is an open access article distributed under the terms of the Creative Commons
E‑mail: cmcl,faimer2@gmail.com Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak,
and build upon the work non‑commercially, as long as the author is credited and the new
References creations are licensed under the identical terms.

1. Abela J. Adult learning theories and medical education: A review. Access this article online
Malta Med J 2009;21:11‑8.
Quick Response Code:
2. McGrath V. Reviewing the evidence on how adult students learn: Website:
An examination of Knowles’ model of andragogy. Irish J Adult www.ijabmr.org
Community Educ 2009;99:110.
3. Kolb DA. Experiential Learning: Experience as the Source of
Learning and Development. Englewood Cliffs, NJ: Prentice Hall; DOI:
1984. 10.4103/ijabmr.IJABMR_385_17
4. Skinner BF. About Behaviourism. London: Cape; 1914.
5. Torre DM, Daley BJ, Sebastian JL, Elnicki DM. Overview
of current learning theories for medical educators. Am J Med How to cite this article: Badyal DK, Singh T. Learning theories:
2006;119:903‑7. The basics to learn in medical education. Int J App Basic Med Res
6. Ponton MK, Rhea NE. Autonomous learning from social 2017;7:S1-3.

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