Definition/Introduction

Learning is the change in the behavior of an organism that is a result of prior experience.[1] Learning theory seeks to explain how individuals acquire, process, retain, and recall knowledge during the process of learning. Environmental, cognitive, and emotional influences, along with prior experiences, play a vital role in comprehending, acquiring, and retaining skills or knowledge. Motivation plays an important role in enabling the process of learning and is said to be the driving force where activity is started and sustained to achieve a target.[2]

It was Plato, the ancient Greek philosopher who first pondered about how an individual learns new information when the subject is brand new to him. According to Plato, learning is a passive process where knowledge is already innately in an individual at birth, and any information acquired is merely a recollection of knowledge the soul already holds. John Locke later offered a contrasting ‘blank slate’ theory where humans are born without any innate knowledge and which is gained from the environment. Since then, there have been numerous different theories proposed about the process of learning.

Issues of Concern

Currently, there are five widely accepted theories of learning.

Behaviorism: According to the theory of behaviorism, learning occurs by linking stimuli and responses. Knowledge is independent, and it becomes cemented by way of punishments and rewards. These ideas of positive and negative reinforcement, which may be natural consequences or implemented by another, are effective tools for learning and behavior modification. Behaviorism focuses on observed actions, the conditions under which they are performed, and the reinforcement of desired behaviors. A change in performance is evident after the learning process, and the outcome is measured in terms of being able to demonstrate a specific new behavior.[3]

Cognitivism: This theory of learning is grounded in the work of Jean Piaget, which states that learning occurs through the processing of information internally rather than merely responding to an external stimulus. Learning is a result of processing and reorganizing information within a matrix of previously acquired information. Cognitivism places the focus on the individual's thought processes and has the teacher emphasize reflecting on experiences with metacognition, thinking about their thinking. The behavioral change seen here is a result of learning which occurs after the inner workings of thinking based on the new information or knowledge received. The learning process encompasses both acquisition and reorganization of cognitive entities.[4]

Constructivism: It is based on the premise that individuals learn by constructing new ideas, and an understanding of the world is based on prior knowledge and experiences. Knowledge is built by adapting new information through the lens of previous experience. Constructivism focuses on the internal thinking of an individual, like cognitivism, but makes no assumptions on how concepts will be manipulated or what links will be made. Since the basis of learning is placed on making connections and creating ideas from prior knowledge, these mental representations are very subjective, and each individual will have a unique construction of knowledge.

Connectivism: This newer educational learning theory is grounded in the notion that learning is through the formation of connections between each other as well as their roles, hobbies, and other aspects of life. Therefore learning is the ability to traverse and construct these networks. Connectivism builds on the ideas of cognitivism, but in this theory, learning does not reside only within an individual, but rather also within and across a network of individuals. A "community of practice" has connectivism as its theoretical underpinning. Knowledge can reside outside the individual, but learning focuses on organizing and locating specialized information that may be decentralized from an individual.[5]

Humanism: This theory is closely related to constructivism and adult learning theory, and states that learning is a natural desire with the ultimate goal of achieving self-actualization.[6] Individuals function under needs that begin from those basic physiological needs of survival and culminate at self-actualization, which rests at the pinnacle of this hierarchy. All humans strive for self-actualization, which refers to a state wherein one feels that all their emotional, physical, and cognitive needs have been fulfilled. Humanistic learning theory emphasizes the freedom and autonomy of learners. It connects the ability to learn with the fulfillment of other needs (building on Maslow's hierarchy) and the perceived utility of the knowledge by the learner.

A learning style, on the other hand, refers to the way an individual prefers to absorb, process, comprehend and retain a new piece of information. While a learning theory explains how learning takes place, a learning style describes the preferred method of learning. Learning styles fall into seven basic categories, namely, physical, logical, social, solitary, visual, aural, and verbal. While descriptions of learning styles exist, catering to a preferred "learning style" leads to no improved outcomes in learning and may guide learners to avoid material presented in a manner that they feel is more uncomfortable.[7]

Clinical Significance

The advances in cognitive and learning sciences theories inform educators about best learning and teaching practices and their impact on the process of evaluation under differing circumstances. An understanding of these theories provides a sound rationale for choosing specific instructional and assessment strategies that measure that the curricular objectives.[8] In recent times, educators have started using social media as a means of instruction, and the sound application of social media in education is traceable to the learning theories.[9]

Implications for Teachers

In behaviorism, the teacher needs to be active and have a good knowledge base to set up the appropriate learning environment and elicit the correct responses from the learners. On the other hand, in cognitivism, the role of the teacher is to structure the content of the learning material. Under the structure of constructivism, the role of a facilitator is played by the teacher, who acts as a guide to the students, each of whom brings a unique set of previous experiences to approach the knowledge they are acquiring. Connectivism requires teachers to guide learners to related areas of knowledge outside their focus. Humanism focuses on learner autonomy and potential, having where teachers encourage learners to be self-directed. Thus we see how behaviorism is teacher-centered, whereas constructivism, connectivism, humanism, and cognitivism are learner-centered approaches.

Curriculum Design and Delivery

Behaviorism: It can be very useful in the sphere of clinical and communication skills because as students are provided feedback over a while, they learn the correct responses while performing skills. Their learning can occur in small chunks with repetition that help learn the intended behavior over some time. Behaviourism also enforces the mastery of prerequisite steps before moving onto other further modules, which ensures reinforcement of the correct skills. While teaching certain skills, the teacher can first demonstrate the technique or manner in which a particular skill is to be performed, after which the students try to imitate the same technique. They would then be assessed based on the perfectly they were able to perform the skill-based on what was demonstrated and receive positive or negative reinforcement.[10]

Cognitivism: Conventional basic science courses that occur in isolation to the clinical course make can use of cognitivism, as new information and knowledge are given and then processed internally to come to new ideas and improve the schemata of knowledge.

Constructivism: For basic science courses that occur integrated with clinical science courses, the theory of constructivism would be more appropriate as the student needs to grasp the concepts of the basic sciences and then be able to construct connections to the clinical aspect of it. Any area that requires knowledge to be acquired and then applied to a different sphere would benefit significantly from constructivism.

Connectivism: The learning process in connectivism is similar to that seen with constructivism. Since learning is through the process of forming connections between previous knowledge and an individual’s innate qualities, this approach is appropriate for areas that require the application of knowledge between different disciplines. It has a particular application for learning and teaching in this digital age.[5]

Humanistic: In the humanistic approach, a teacher would allow students to learn by their own free will and desire for knowledge. Since humanists believe that the desire to learn is innate and aimed towards the ultimate goal of self-actualization, the motivation must come from the learner. Although there is often a clear minimal structure for the teaching, the responsibility is on the students to learn as they wish to.[11]

Nursing, Allied Health, and Interprofessional Team Interventions

The most salient or easily applied strategums from the aforementioned learning theories can be administered when educating patients. Understanding the nuances of learning can help improve patient compliance, leading to an improved prognosis. Thus, it is imperative for interprofessional teams to understand which teaching modalities may engender the best compliance.