Principles and Theories in Teaching and Learning

A. Learning Theories Related to Health Care Practice:

LEARNING

- Is defined as a relatively permanent change in mental processing, emotional functioning,

skill, and/or behavior as a result of exposure to different experiences. It is the lifelong,

dynamic process by which individuals acquire new knowledge or skills and alter their

thoughts, feelings, attitudes, and actions.

- Complex process which involves changes in mental processing, development of emotional

functioning and social transactional skills which develop and evolve from birth to death.

- Enables individuals to adapt to demands and changing circumstances and is crucial in health

care

How does learning occur?

- Learning occurs as the individual interacts with his/her environment and incorporates or

applies new information or experiences to what he/she already knows or has learned.

What kinds of experiences facilitate or hinder the learning process?

a. Teacher’s selection of learning theories to be applied and structuring or type of learning

experience are very important considerations;

b. Teacher’s knowledge of the nature of the learner, the materials to be learned, teaching

methods to be employed, communication skills, and ability to motivate the learner;

c. The teacher’s ability to relate new knowledge to previous experiences, values, selfperception and the
learner’s readiness to learn are also some of the many factors that may

facilitate or hinder learning.

Learning Theories

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.

Learning theories, teaching and learning techniques and strategies based on scientific studies.

Educational Psychology as being research-based

The start of the twentieth century saw the emergence of a new field known as

EDUCATIONAL PSHYCOLOGY - it is concerned with systematic evidence and data-gathering which are
used to test theories and hypotheses about learning.

Why the Health Professional Needs to Know the Nature of the Learner

o Learning theories put together concepts and propositions to explain “why people

learn and predict under what circumstances they will learn”

o There is no single theory that can be considered as the best answer to these

questions. The definition of learning theory that is being used

Contribution 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 patients/clients, staff

training and education and in carrying out continuing health education and promotion

programs.

To understand the nature of the learner, the health professional needs to know some basic principles

involved in the development and maturation of the individual. Human development is the dynamic

process of change that occurs in the physical, psychological, social, spiritual, and emotional constitution

and make-up of an individual which starts from the time of conception to death (from womb to tomb). It

is the scientific study of the changes that occur in people as they age or grow older in years. These

changes may entail:

1. Growth which is quantitative involving increase in the size of parts of the body

2. Development which is qualitative involving gradual changes in character

As the person grows and develops, 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. Preprogrammed inherited biological

patterns are reflected in maturation.

1. Behaviorist

I. Behaviorist learning theory

- John B. Watson is the proponent of 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 associated with the Stimulus-Response Psychology. He postulated

that behavior results from a series of condition reflexes and that all emotions and thoughts

are a product of behavior learned through conditioning (de Young, 2003)

A. RESPONDENT CONDITIONING

Respondent conditioning (also termed association learning, classical conditioning, or

Pavlovian conditioning)

- A neutral stimulus (NS) – a stimulus that has no special value or meaning to the

learner – is paired with a naturally occurring unconditioned or unlearned stimulus

(UCS) and unconditioned response (UCR). After a few such pairings, the neutral

stimulus alone elicits the same unconditioned response. Thus, learning takes place

when the newly conditioned response (CR) – a process that may well occur without

conscious thought or awareness.

Systematic desensitization - A technique based on respondent conditioning that is used by

psychologists to reduce fear and anxiety in their clients.

Stimulus generalization - the tendency of initial learning experiences to be easily applied to

other stimuli.

Discrimination learning- Various experiences individuals learned to differentiate among

similar stimuli

Spontaneous recovery -A useful respondent conditioning concept that needs to be given

careful consideration in relapse prevention program. Although a response may appear to be

extinguished, it may recover or reappear at any time (even years later), especially when

stimulus conditions are similar to those in the initial learning experience. It helps us

understand why it is difficult to eliminate completely bad/unhealthy habits such as smoking,

alcoholism, drug abuse.

B. OPERANT CONDITIONING

Operant conditioning

Focuses on the behavior of the organism and reinforcement that occurs after

the response.
 operant conditioning model: contingencies to increase and decrease the

probability of an organism’s response

To increase the probability of a response:

A. Positive reinforcement: application of a pleasant stimulus

Reward conditioning: a pleasant stimulus is applied following an organism’s

response

B. Negative reinforcement: removal of an aversive or unpleasant stimulus.

Escape conditioning: as an aversive stimulus is applied, the organism makes a

response that causes the unpleasant stimulus to cease.

Avoidance conditioning: an aversive stimulus is anticipated by the organism, which

makes a response to avoid the unpleasant event.

To decrease or extinguish the probability of a response:

A. Nonreinforcement: an organism’s conditioned response is not followed by any

kind of reinforcement (positive, negative, or punishment)

B. Punishment : following a response, an aversive stimulus is applied that the

organism cannot escape or avoid.

Escape conditioning - An unpleasant stimulus is being applied, the individual responds in some

way that causes the uncomfortable stimulation to cease.

Avoidance conditioning - The unpleasant stimulus is anticipated rather than being applied

Directly

History of Behaviorism

A basic understanding of behaviorism can be gained by examining the history of four of the most

influential psychologists who contributed to the behaviorism: Ivan Pavlov, Edward Thorndike, John B.

Watson, and B.F. Skinner. These four did not each develop principles of behaviorism in isolation, but

rather built upon each other’s work.

Ivan Pavlov

Ivan Pavlov is perhaps most well-known for his work in conditioning dogs to salivate at the sound of a

tone after pairing food with the sound over time. Pavlov’s research is regarded as the first to explore

the theory of classical conditioning: that stimuli cause responses and that the brain can associate
stimuli together to learn new responses. His research also studied how certain parameters — such as

the time between two stimuli being presented — affected these associations in the brain. His

exploration of the stimulus-response model, the associations formed in the brain, and the effects of

certain parameters on developing new behaviors became a foundation of future experiments in the

study of human and animal behavior (Hauser, 1997).

In his most famous experiment, Pavlov started out studying how much saliva different breeds of dogs

produced for digestion. However, he soon noticed that the dogs would start salivating even before the

food was provided. Subsequently he realized that the dogs associated the sound of him walking down

the stairs with the arrival of food. He went on to test this theory by playing a tone when feeding the

dogs, and over time the dogs learned to salivate at the sound of a tone even if there was no food

present. The dogs learned a new response to a familiar stimulus via stimulus association. Pavlov

called this learned response a conditional reflex. Pavlov performed several variations of this

experiment, looking at how far apart he could play the tone before the dogs no longer associated the

sound with food; or if applying randomization — playing the tone sometimes when feeding the dogs

The Students' Guide to Learning Design and Research 2

but not others — had any effect on the end results (Pavlov, 1927).

Pavlov’s work with conditional reflexes was extremely influential in the field of behaviorism. His

experiments demonstrate three major tenets of the field of behaviorism:

1. Behavior is learned from the environment. The dogs learned to salivate at the sound of a tone

after their environment presented the tone along with food multiple times.

2. Behavior must be observable. Pavlov concluded that learning was taking place because he

observed the dogs salivating in response to the sound of a tone.

3. All behaviors are a product of the formula stimulus-response. The sound of a tone caused no

response until it was associated with the presentation of food, to which the dogs naturally

responded with increased saliva production.

These principles formed a foundation of behaviorism on which future scientists would build.

Edward Thorndike

Edward Lee Thorndike is regarded as the first to study operant conditioning, or learning from

consequences of behaviors. He demonstrated this principle by studying how long it took different
animals to push a lever in order to receive food as a reward for solving a puzzle. He also pioneered

the law of effect, which presents a theory about how behavior is learned and reinforced.

One experiment Thorndike conducted was called the puzzle box experiment, which is similar to the

classic “rat in the maze” experiment. For this experiment, Thorndike placed a cat in a box with a

piece of food on the outside of the box and timed how long it took the cat to push the lever to open

the box and to get the food. The first two or three times each cat was placed in the box there was

little difference in how long it took to open the box, but subsequent experiments showed a marked

decrease in time as each cat learned that the same lever would consistently open the box.

A second major contribution Thorndike made to the field is his work in pioneering the law of effect.

This law states that behavior followed by positive results is likely to be repeated and that any

behavior with negative results will slowly cease over time. Thorndike’s puzzle box experiments

supported this belief: animals were conditioned to frequently perform tasks that led to rewards.

Thorndike’s two major theories are the basis for much of the field of behaviorism and psychology

studies of animals to this day. His results that animals can learn to press levers and buttons to

receive food underpin many different types of animal studies exploring other behaviors and created

the modern framework for the assumed similarities between animal responses and human responses

(Engelhart, 1970).

In addition to his work with animals, Thorndike founded the field of educational psychology and

wrote one of the first books on the subject, Educational Psychology, in 1903. Much of his later career

was spent overhauling the field of teaching by applying his ideas about the law of effect and

challenging former theories on generalized learning and punishment in the classroom. His theories

and work have been taught in teaching colleges across the world.

John B. Watson

John Broadus Watson was a pioneering psychologist who is generally considered to be the first to

The Students' Guide to Learning Design and Research 3

combine the multiple facets of the field under the umbrella of behaviorism. The foundation of

Watson’s behaviorism is that consciousness — introspective thoughts and feelings — can neither be

observed nor controlled via scientific methods and therefore should be ignored when analyzing

behavior. He asserted that psychology should be purely objective, focusing solely on predicting and
controlling observable behavior, thus removing any interpretation of conscious experience. Thus,

according to Watson, learning is a change in observable behavior. In his 1913 article “Psychology as

the Behaviorist Views It”, Watson defined behaviorism as “a purely objective experimental branch of

natural science” that “recognizes no dividing line between man and brute.” The sole focus of

Watson’s behaviorism is observing and predicting how subjects outwardly respond to external

stimuli.

John Watson is remembered as the first psychologist to use human test subjects in experiments on

classical conditioning. He is famous for the Little Albert experiment, in which he applied Pavlov’s

ideas of classical conditioning to teach an infant to be afraid of a rat. Prior to the experiment, the

nine-month-old infant Albert was exposed to several unfamiliar stimuli: a white rat, a rabbit, a dog, a

monkey, masks with and without hair, cotton wool, burning newspapers, etc. He showed no fear in

response. Through some further experimentation, researchers discovered that Albert responded with

fear when they struck a steel bar with a hammer to produce a shap noise.

During the experiment, Albert was presented with the white rat that had previously produced no fear

response. Whenever Albert touched the rat, the steel bar was struck, and Albert fell forward and

began to whimper. Albert learned to become hesitant around the rat and was afraid to touch it.

Eventually, the sight of the rat caused Albert to whimper and crawl away. Watson concluded that

Albert had learned to be afraid of the rat (Watson & Rayner, 1920).

By today’s standards, the Little Albert experiment is considered both unethical and scientifically

inconclusive. Critics have said that the experiment “reveals little evidence either that Albert

developed a rat phobia or even that animals consistently evoked his fear (or anxiety) during Watson’s

experiment” (Harris, 1997). However, the experiment provides insight into Watson’s definition of

behaviorism — he taught Albert by controlling Albert’s environment, and the change in Albert’s

behavior led researchers to conclude that learning had occurred.

B. F. Skinner

Skinner was a psychologist who continued to influence the development of behaviorism. His most

important contributions were introducing the idea of radical behaviorism and defining operant

conditioning.

Unlike Watson, Skinner believed that internal processes such as thoughts and emotions should be
considered when analyzing behavior. The inclusion of thoughts and actions with behaviors is radical

behaviorism. He believed that internal processes, like observable behavior, can be controlled by

environmental variables and thus can be analyzed scientifically. The application of the principles of

radical behaviorism is known as applied behavior analysis.

In 1938, Skinner published The Behavior of Organisms, a book that introduces the principles of

operant conditioning and their application to human and animal behavior. The core concept of

operant conditioning is the relationship between reinforcement and punishment, similar to

Thorndike’s law of effect: Rewarded behaviors are more likely to be repeated, while punished

behaviors are less likely to be repeated. Skinner expounded on Thorndike’s law of effect by breaking

The Students' Guide to Learning Design and Research 4

down reinforcement and punishment into five discrete categories (cf. Fig. 1):

Positive reinforcement is adding a positive stimulus to encourage behavior.

Escape is removing a negative stimulus to encourage behavior.

Active avoidance is preventing a negative stimulus to encourage behavior.

Positive punishment is adding a negative stimulus to discourage behavior.

Negative punishment is removing a positive stimulus to discourage behavior.

Reinforcement encourages behavior, while punishment discourages behavior. Those who use operant

conditioning use reinforcement and punishment in an effort to modify the subject’s behavior.

Figure 1

An Overview of the Five Categories of Operant Conditioning

Positive and negative reinforcements can be given according to different types of schedules. Skinner

developed five schedules of reinforcement:

Continuous reinforcement is applied when the learner receives reinforcement after every

specific action performed. For example, a teacher may reward a student with a sticker for each

meaningful comment the student makes.

Fixed interval reinforcement is applied when the learner receives reinforcement after a fixed

amount of time has passed. For example, a teacher may give out stickers each Friday to

students who made comments throughout the week.

Variable interval reinforcement is applied when the learner receives reinforcement after a
random amount of time has passed. For example, a teacher may give out stickers on a random

day each week to students who have actively participated in classroom discussion.

Fixed ratio reinforcement is applied when the learner receives reinforcement after the

behavior occurs a set number of times. For example, a teacher may reward a student with a

sticker after the student contributes five meaningful comments.

Variable ratio reinforcement is applied when the learner receives reinforcement after the

behavior occurs a random number of times. For example, a teacher may reward a student with

a sticker after the student contributes three to ten meaningful comments.

Skinner experimented using different reinforcement schedules in order to analyze which schedules

The Students' Guide to Learning Design and Research 5

were most effective in various situations. In general, he found that ratio schedules are more resistant

to extinction than interval schedules, and variable schedules are more resistant than fixed schedules,

making the variable ratio reinforcement schedule the most effective.

Skinner was a strong supporter of education and influenced various principles on the manners of

educating. He believed there were two reasons for education: to teach both verbal and nonverbal

behavior and to interest students in continually acquiring more knowledge. Based on his concept of

reinforcement, Skinner taught that students learn best when taught by positive reinforcement and

that students should be engaged in the process, not simply passive listeners. He hypothesized that

students who are taught via punishment learn only how to avoid punishment. Although Skinner’s

doubtful view on punishment is important to the discipline in education, finding other ways to

discipline are very difficult, so punishment is still a big part in the education system.

Skinner points out that teachers need to be better educated in teaching and learning strategies

(Skinner, 1968). He addresses the main reasons why learning is not successful. This biggest reasons

teachers fail to educate their students are because they are only teaching through showing and they

are not reinforcing their students enough. Skinner gave examples of steps teachers should take to

teach properly. A few of these steps include the following:

1. Ensure the learner clearly understands the action or performance.

2. Separate the task into small steps starting at simple and working up to complex.

3. Let the learner perform each step, reinforcing correct actions.

5. Change to random reinforcement to maintain the learner’s performance (Skinner, 1968).

Criticisms and Limitations

While there are elements of behaviorism that are still accepted and practiced, there are criticisms

and limitations of behaviorism. Principles of behaviorism can help us to understand how humans are

affected by associated stimuli, rewards, and punishments, but behaviorism may oversimplify the

complexity of human learning. Behaviorism assumes humans are like animals, ignores the internal

cognitive processes that underlie behavior, and focuses solely on changes in observable behavior.

From a behaviorist perspective, the role of the learner is to be acted upon by the teacher-controlled

environment. The teacher’s role is to manipulate the environment to shape behavior. Thus, the

student is not an agent in the learning process, but rather an animal that instinctively reacts to the

environment. The teacher provides input (stimuli) and expects predictable output (the desired change

in behavior). More recent learning theories, such as constructivism, focus much more on the role of

the student in actively constructing knowledge.

Behaviorism also ignores internal cognitive processes, such as thoughts and feelings. Skinner’s

radical behaviorism takes some of these processes into account insofar as they can be measured but

does not really try to understand or explain the depth of human emotion. Without the desire to

understand the reason behind the behavior, the behavior is not understood in a deeper context and

reduces learning to the stimulus-response model. The behavior is observed, but the underlying

cognitive processes that cause the behavior are not understood. The thoughts, emotions, conscious

state, social interactions, prior knowledge, past experiences, and moral code of the student are not

taken into account. In reality, these elements are all variables that need to be accounted for if human

behavior is to be predicted and understood accurately. Newer learning theories, such as cognitivism,

The Students' Guide to Learning Design and Research 6

focus more on the roles of emotion, social interaction, prior knowledge, and personal experience in

the learning process.

Another limitation to behaviorism is that learning is only defined as a change in observable behavior.

Behaviorism operates on the premise that knowledge is only valuable if it results in modified

behavior. Many believe that the purpose of learning and education is much more than teaching
everyone to conform to a specific set of behaviors. For instance, Foshay (1991) argues that “the one

continuing purpose of education, since ancient times, has been to bring people to as full as realization

as possible of what it is to be a human being” (p. 277). Behaviorism’s focus on behavior alone may not

achieve the purpose of education, because humans are more than just their behavior.

Conclusion

Behaviorism is a study of how controlled changes to a subject’s environment affect the subject’s

observable behavior. Teachers control the environment and use a system of rewards and punishments

in an effort to encourage the desired behaviors in the subject. Learners are acted upon by their

environment, forming associations between stimuli and changing behavior based on those

associations.

There are principles of behaviorism that are still accepted and practiced today, such as the use of

rewards and punishments to shape behavior. However, behaviorism may oversimplify the complexity

of human learning; downplay the role of the student in the learning process; disregard emotion,

thoughts, and inner processes; and view humans as being as simple as animals.

2. Cognitive

II. Cognitive Learning Theory

- Theorists that follow this stress the importance of what goes on inside the learner. Cognitive

theory composed of sub theories and is widely used in education and counseling. Unlike

behaviorists, cognitive theorists maintain that reward is not necessary for learning to take place.

More important are learners’ goals and expectations.

Metacognition - A person’s understanding of his/her way of learning

Gestalt perspective - Emphasizes the importance of perception in learning and lays the

groundwork for various other cognitive perspective that followed.

Information processing - A cognitive perspective that emphasizes thinking processes; thought,

reasoning, the way information is encountered and stored, and memory function.

Cognitive development - A third perspective that focuses on qualitative changes in perceiving

thinking, and reasoning as individuals grow and mature.

Social constructivism - A centra tenet of the social constructivist, their approach is that

ethnicity, social class, gender, family life, life history, self-concept, and the learning situation
itself all influence an individual’s perceptions, thoughts, emotions, interpretations, and

responses to information and experiences.

Social cognition -This perspective reflects the constructivists’ orientation and highlights the

influence of social factors on perception, thought, and motivation.

Attribution theory - Focuses on the cause-and-effect relationships and explanations that

individuals formulate to account for their own and other’s behavior and the way in which the

world operates.

Cognitive-emotional perspective - Being criticized for neglecting emotions, efforts have been

made may theorists to incorporate considerations related to emotions within a cognitive

framework

Emotional Intelligence - An individual’s ability to manage his emotions, motivating himself,

reading the emotions of others, and working effectively in interpersonal relationships.

Self-regulation - The ability to self-regulate; includes learners ability to monitor their own

cognitive processes, emotions, and surroundings, to achieve goals.

3. Social

III. Social Learning Theory

- Is largely based on the work of Albert Badura (1997, 2001), who mapped out a perspective on

learning that includes considerations of the personal characteristics if the learner, behavioral

patterns, and the environment. Since it’s inception, this theory has undergone several

“paradigm shifts”. As Bandura’s social learning has evolved, the learner is now viewed as central,

which suggests the need to identify the learners are perceiving and how they are interpreting

and responding to social situations.

Role modeling - A central concept of social learning theory; Armstrong (2008) emphasizes that

to facilitate learning, role models need to be enthusiastic, professionally organized, caring, and

self-confident as well as knowledgeable, skilled, and good communicators.

Vicarious reinforcement - Another concept from social learning theory, involves determining

whether role models are perceived as rewarded or punished for their behavior.