Describe various theories of nursing instruction

Read the Langley and Brown (2010) study. In this literature review reflective journaling and its role in promoting critical thinking
and nursing theory integration into practice is discussed. From the McEwen and Wills chapter 16 reading, select either a cognitive or
behavioral learning theory. Create a reflective journaling assignment you would provide nursing students at the BSN level.
1. Present the assignment instructions as you would provide them for your students.
2. Explain/discuss which learning theory you used as the basis and why.
3. What are your learning goals for the students?
4. How will this assignment and the theory achieve those goals?
Post response no later than Tuesday. Responses need to address all components of the question, demonstrate critical thinking and
analysis, and include peer reviewed journal evidence to support the student’s position. Please see grading rubric for additional
requirements
Students are expected to:
1. Post an initial substantive response of 200-250 words to each question.
2. Read postings and engage in the discussion boards 4-5 days per week.
3. Respond to at least two other student’s postings with substantive comments.
Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning
environment.
The postings should be at least one paragraph (approximately 100 words) and include references as indicated by the instructor.
4. References and citations should conform to the APA 6th edition.
Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
Plagiarism is never acceptable – give credit when credit is due – cite your sources
• McEwen and Wills (2011) Chapters 20
•
Langley, M. E., & Brown, S. T. (2010). PERCEPTIONS of the use of reflective learning journals in online graduate nursing education.
Nursing Education Perspectives, 31(1), 12-7. Retrieved from http://www.nlnjournal.org/
To review, here are the concepts we discussed last week:
 Nursing leadership theories come from a variety of management, social science and behavioral theories
 Balance is essential in all leadership endeavors
 Leadership requires self-reflection and self-development
 Understanding one’s own leadership philosophy and its relationship to core nursing values will strengthen leadership skills in
all specialties and focus areas
 It’s essential to understand one’s organizational structure when applying leadership theories to nursing
 Nurse leaders have unique responsibilities
 Theory and practice can be joined at all levels of the organization. It depends on your focus!
 Ruland and Moore’s middle range theory is an example of how leadership can be applied to variety of clinical situations
Slide 2
This week our objectives include
 Explain application of theory to nursing curricula
 Describe various theories of nursing instruction
 Distinguish between various learning theories
 Understand difference between cognitive and behavioral theory
Slide 3
Key terms we will cover include
 Learning Style
 Cognitive
 Affective
 Psychomotor
 Behaviorism
 Gestalt
 Benner’s Novice to Expert
 Knowles
 Adult Learners
Education theory is core to everything we do as nurses, so this should be a fun and interesting module!
Slide 4
Teaching and learning occur on a continuum. It’s not only us as leaders, practitioners and educators who provide teaching. It’s also
patients who in turn communicate with us and educate us on their unique needs. Consider the systems theories we reviewed at the
beginning of the course. In order to understand the learning needs of a person or environment, it’s necessary to determine what
elements feed into the system, and where a learning opportunity may be present. If you don’t understand the system and its unique
elements you won’t be effective regardless of which role you fulfill. For example if there are certain religious or gender constraints
focusing your teaching activities to the wrong group of individuals won’t be effective.
Slide 5
Educators also need to understand the types of learning styles that are most effective for people. If you have implemented patient
teaching and it isn’t effective, it may be time to consider why your approach has failed. It is generally accepted that people may
learn best from a cognitive, affective or psychomotor framework. There are also interventions that work for each of these. Cognitive
learners prefer to gather and study information. They pull from a variety of sources and are the students buried in research articles
in the library. They may be characterized by the patient who arrives with an armful of downloaded internet research which may or may
not be of benefit. Of course we all learn this way, but for cognitive learners it is a preference. The affective learner is more likely
to explore beliefs and perception. If they want to learn about a culture, instead of setting up camp in the library they may prefer a
phenomenological research study where they go to the culture and live in it for a set period of time to truly experience, discuss and
express its qualities. Finally psycho-motor learners learn best by doing. Running through practice in the skills lab is the most
effective for this type of learner.
Slide 6
One thing to remember as an educator is that your goal is to impart knowledge, change behavior and ensure that teaching has happened.
It’s not enough to stand at the front of a class and impart your message. You are responsible for ensuring your message is
appropriately designed to be understandable and usable for your audience. It’s important not to use a simplistic approach in which you
just expect compliance from your learning audience because you’ve told them the right approach or behavior. Understanding the cognitive
processes of your audience will help you better design instruction that is effective. This is true regardless of what nursing specialty
track you choose.
Slide 7
So, where does theory fit into this? In some ways it’s easier to understand practice and systems theory where you influence objective
measures such as temperature or nutrition. Learning is much more subjective and you may not be sure if learning has occurred until much
later. It’s not as simple as giving Tylenol and checking the temperature again in an hour to determine effect. Learning and teaching
theories help practitioners follow consistent frameworks that can be tested over time. Using a consistent framework helps you determine
where your process is working or is not working when you look at your outcomes. Theory also helps educators develop a common language
across which new concepts can be developed and shared. There are many types of learning theories. We will begin first with some very
broad theories that have impacted nursing theories, and then during part two this week delve into some more specifics.
Slide 8
What’s great about the fact that learning theory is founded in a variety of existing theories and philosophies is that the foundation
has been tested over time and in a variety of situations. We address the same audience as that which other researchers have explored
for decades through the fields of essay/experimental-psychology-psychological-research-statistics/”>psychology, sociology and management. This makes core concepts applicable to every facet of the
nursing process.
Slide 9
Understanding how concepts of reward, motivation, education, life experience and personal beliefs factor into learning is also
important. Consider Rogers’ Theory of Unitary Beings which we visited during module 3. According to Rogers we are all connected in an
energetic framework through which higher levels of functioning are possible. These subjective and abstract elements guide
decisionmaking in a variety of frameworks. We may not even be consciously aware of how the elements she identifies guide us. So where
can you begin to make theory practical at the point of care level!
Slide 10
Let’s start at a place which is about the furthest we can get from Rogers’ unitary theory! Behaviorism. B.F. Skinner and Ivan Pavlov
are the progenitors of behavioral theory. Their theories were some of the first ones to be applied to the U.S. education system in the
1950’s. Stimuli are believed to drive behavioral response. So with either a positive or negative stimulus behaviors can be learned over
time. Some concepts across behavioral theorists include that learners begin as essentially “empty” organisms that can then be trained
to believe and behave in a certain manner depending on the type of stimulus provided. In classical conditioning, Pavlov’s research, the
response to a stimulus is involuntary and based on experience. Clearly, his salivating dogs didn’t salivate because they thought it
over and decided to. It became an involuntary response. Operant conditioning, espoused by Skinner, proposed that behaviors are
consciously chosen in order to receive a certain type of stimulus, such as a reward. This way even when the reward goes away the desire
to complete the behavior continues because it’s associated with pleasant results.
Slide 11
One of the greatest limitations of behavioral theory is it doesn’t take into account the unique elements of individual learning and
experience. The concept that everyone begins as an empty vessel has since been challenged by essay/experimental-psychology-psychological-research-statistics/”>psychology. However, there continue to be
positive elements that are used by nurses regularly. Providing positive feedback is a form of behavioral conditioning focused on
encouraging learners to develop new behaviors.
Slide 12
Cognitive learning theories see the mind as the central point in learning. While behaviorism tend to ignore the thoughts and feelings
of the individual, cognitive learning theory embraces these elements and attempts to design learning within the framework of the
learner’s mind. Jean Piaget’s learning theory which we all cover in our pediatrics courses fall under the framework of cognitive
learning theory.
Slide 13
Cognitive learning theory proposes that perception is a key element in learning. How you perceive an event, opportunity or activity
greatly affects its ability to change your behavior. If you think something is generally beneficial, or if you are suspicious of it due
to cultural beliefs is important. If we understand where one person’s perception may conflict with medical recommendations it’s
possible to either change the recommendations to support the perception of the individual, or attempt to change perception in order to
make recommendations useful.
Slide 14
Motivation is also a core element of perception and learning. If there is low motivation the work of an educator will be much more
challenging. Perhaps motivation is due to a fatalistic belief. If that belief, or perception, can be changed then learning can occur.
Understanding what motivates your clients is a significant benefit to designing the right types of teaching opportunities.
Slide 15
Remember Benner’s theory of novice to expert! We discussed that in the first couple weeks of the course. All of the above learning
styles and theories can be used to help design curricula at any point of Benner’s continuum. Let’s look more closely at that in the
second part of our lecture.
Slide 16
 Nursing theories of learning integrate many philosophies, theories and approaches
 Understand your audience and its specific learning needs
 Determine where learning can be best focused
 Identify problems of motivation and perception
 Learning happens on a continuum. Patricia Benner’s theory can be applied to all clinical environments and specialties

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