Learning and Teaching in Healthcare Setting

Introduction to Learning in Healthcare Education

Learning theories serve as a primary guide for education system structuring and planning. In healthcare, learning theories are applied to the development of classroom training and applied practice (Aliakbari et al. 2015). The purpose of these theories is to understand the psyche of learning and make the education practicum more engaging to promote its retention and understanding among the students (Lavoie et al. 2018). This essay will evaluate the application of learning theories in the healthcare education and assess their implementation with focus on a 21st Century learner. Further, this essay will also reflect on an education program focused on the application of MSE (Mental State Examination) assessment and reflect on how the suitable learning theories can be applied for same. This essay will also provide recommendations to improve education practice and facilitate a better learning code.

Literature Review of Learning Theories

Education psychology has vividly explored the learning theories to understand their application to enhance the process of learning and to guide the teaching processes. The importance of learning theories in education has been explored by Lavoie et al. (2018) who assert that learning theories are beneficial not only for the improvement in the delivery of education but also for the formulation of pedagogy and education infrastructure. Mukhalalati & Taylor (2019) identify that learning theories have a critical significance in healthcare education where the process of learning and information retaining plays a critical role in the community well being. Kelly et al. 2016 have classified the learning theories into three broad categories, that are, behaviourism, cognitive theories, and constructivism. The behaviourism theories are dominantly used in psychology education where learners are engaged in the study through behavioural reinforcement (Mukhalalati & Taylor 2019). The common behavioural theories that are applied in the pedagogy include Pavlov’s Classical Conditioning theory and Bernard’s theory of learning. Other common learning theories that are based on the behavioural learning of an individual include Thorndike theory and Theory of transponders conditioning. Keating & DeBoor (2016) have focused on the application of the behavioural theories in healthcare education. This has been suggested on the basis of how to practice methods on mannequins can help in boosting participation and confident of the learners through the achievement of the desired results (Stoffels et al. 2019). The Thorndike theory has also been applied in nursing education and plays a critical role in education transfer (Aliakbari et al. 2015). Students in the clinical setting encounter a range of experiences that require interdisciplinary integration. This requires the use of combinatorial skills that include argument, attention, memory, and judgement (Gandhi & Mukerjee 2020). These skills can be applied by the healthcare professionals that can enhance the overall practice by improving the critical skills. The Skinner’s conditioning theory has also been reviewed and assessed to improve the overall learning environment, promote competent behaviour, and promote learning (Aliakbari et al. 2015).

The cognitive learning theories focus on targeting the internal learning processes to improve the overall experience of education. The cognitive theories thereby rely on the processes of thinking, understanding, organizing, and consciousness. One of the most popular cognitive theories that are applied in education is known as Gestalt theory. The application of this theory has been studied by Abelsson (2017) with prime focus on the fact that learning combined with understanding has a greater impact of retention than the mechanical repetition of the excitation response relationship. These principles can be implied in the healthcare system with the focus on the training sessions for the assessment and diagnosis. This will promote critical thinking and facilitate the process of decision making in the nurses. Other popular cognitive theories that can be applied in learning and pedagogy include the Piaget's cognitive development theory and the Lev Vygotsky’s cognition and social development theory. Murdoch & Vinek (2017) assert that the application of these theories can help in the development of nursing and health care professionals that understand the importance of learning. The application of this method has been in special consideration with clinical and psychological skills. Several humanist theories have also been applied in learning that focus on the self-actualization in the behaviour for enhanced learning or teaching experience. Modelling theories also enhance the learning experience of an individual where a good role model is an individual who is able to act and behave as per the desired role. The focus of such theories has been elucidated by Kardong-Edgren et al. (2019), who asserts that internalization of the ideal behaviour in learning helps not only understanding of the behaviour that is appropriate but also promoted adherence and retention of the established codes. Kardong-Edgren et al. (2019) have also explored constructivist theories in learning. The constructivist theories have a different approach than the common learning theories as they are based on the reality of a learner. The theory is one of the most applied theories in learning through “experiential learning” where activities guide the process of learning and facilitate understanding. Multiple factors have been associated with the process of retention and memory in leaning. Johnson (2020) argues that in pedagogy many teachers use different ways to maximize learning and retention in the individuals. These ways include changing of stimulus, use of movement, and changes in teaching methods to promote the focus of the learners. The focus of teaching in education largely relies on focus on limitation of attention span, amount and degree of new information presented (Männistö et al. 2020). The focus of the theories is on how the information is presented and applied to ensure retention and limit fatigue. It has been asserted that suitable use of these learning theories can help in the improvement of quality of education provided and also promote the overall learning experience (Männistö et al. 2020).

Adoption of Healthcare Education Strategies

The application of learning theories should be promoted in the healthcare sciences as it promotes clear reasoning, educational activities, enhances the interaction between the patients/ clients, and promotes the overall quality of healthcare practice (Aliakbari et al. 2015). The nurses are responsible for the activities that include design and implementation of the healthcare systems and interventions and thus, adequate learning of various dimensions and their retention in the learners become critical. Application of learning theories in healthcare education has been diverse (Johnson 2020). The behavioural theories are largely applied in the clinical training of the nurses in mental healthcare with the focus on the mental motive. Behavioural theories have been beneficial in the promotion of competence in healthcare nursing and promote the learning outcomes in nursing. Cognitive learning theories are popular for training the students by affecting the intellectual systems at all three levels, enactive, iconic, and symbolic (Bernard 2019). Cognitive theories are also suitable and applied in healthcare education for the establishment of understanding of body systems and multitasking actions that are required in the healthcare practice. The theory of constructivism has also been applied and used in healthcare education. The theory if constructivism in learning can provide the learners with a way to actively participate in the discussions and understand the various perspectives associated with the same (Yancey et al. 2019). The application theory can also be ensured to strengthen the coordination and cooperation among the students and as future professionals. The humanist theory application in healthcare education is a broad based approach and promotes the student-teacher relationship. The learning theories in healthcare education play a crucial role in understanding the established codes and conducts (Abelsson 2017). The purpose of the codes of practice is to ensure that the high quality practice is ensured and the care needs of the patients are met. Further, the codes also serve to be a directive for action. Suitable application of the learning theories can facilitate the process of argument, attention, judgement, and memory. Students in the healthcare system encounter several points that require combined action (Kardong-Edgren et al. 2019). The Skinner’s conditioning theory is widely applied in many healthcare education systems and serves a scientific theory by providing the learning methods for a set of principles and the techniques. The skinner tool is applied for the assessment of behaviour and the outcomes (Keating & DeBoor 2016).

However, the application of learning theories in the pedagogy has been based on traditional teaching and learning. As there is a rise in need of a multidisciplinary action in care and mutating perspective and approaches by the learners (Johnson 2020). Therefore, the pedagogy and education should be focused on the application of multiple theories in the best interest of teaching.

Education Program with The Application of Learning Theories

The purpose of the education program that will be conducted will be to teach the mental health nursing students about the application of Mental State Examination tool for health assessments Mental State Examination assesses the level of consciousness of an individual, notes down the appearance and general behaviour (Lavoie et al. 2018). The Mental state examination also assesses the speech and motor activity and notes the affect and mood of an individual. Other critical observations that are made in the Mental state examination include thought and perception, attitude and insights and the reaction to the patient (Ryan et al. 2019). The examination also includes a structured examination of cognitive abilities. The learning theories that can be applied in this teaching are the theory of constructivism. The constructivist theory is focused on applied learning and thus aims to enhance the engagement and participation along with increased activity and engagement. The modelling approach can also be used where the conduct of the Mental State Examination can be demonstrated to the learners (Mahendran et al. 2019). The modelling approach is suitable in this education program as it will help the learners observe the conduct of a mental state examination and thus facilitate the learning. The humanist theory of learning is a broad spectrum but of prime importance in mental health nursing. The learning theory will be included in the education program by asserting the need for person-centered care and rapport building with the patient (Lavoie et al. 2018). The building of rapport with the patient should be deliberated through effective communication that can be demonstrated through modelling of the exam in the education program and by assertion through the humanist theory (Abelsson 2017). The behavioural and constructivist theories can be used by the learners to apply the teachings from the education program. The education program based on Mental State Examination conduct can be categorized as a successful attempt on the application of learning theories for a new age learner of 21st century for the prime reason that it ensured the application of observational, behavioural and the cognitive aspects of learning (Aliakbari et al. 2015).

Recommendations for Improvement

The education program could be further improved by the inclusion of the learner’s experience in teaching (Aliakbari et al. 2015). A reflective framework for mental state examination conduct could have been beneficial in understanding the perspectives of learners and thus improve the overall quality of the program. The process of adult learning is associated with self-investment (Mukhalalati & Taylor 2019). Therefore, increased participation and engagement of the learners should be focused on. The clinical aspects of improvement of action of the healthcare learners could be assessed for improvement in the program. Feedback could have been taken from the students to assess the understanding of the program (Murdoch & Vinek 2017).

Conclusion on Learning in Healthcare Education

This paper assesses the learning theories that have been developed through the exploration of the available literature. This paper also assesses how the adoption of the learning theories has impacted the healthcare education. Through this analysis, it can be concluded that the healthcare education has adopted learning theories in several aspects. However, improvement is needed in terms of evolving the theories for multidisciplinary and integrated application. This paper also summarizes a healthcare education program designed. The recommendations to improve this program to further enhance the pedagogy have also been included.

References for Learning in Healthcare Education

Abelsson, A, 2017, ‘Learning through simulation’, Disaster and Emergency Medicine Journal, vol.2, no.3, pp. 125-128. https://journals.viamedica.pl/disaster_and_emergency_medicine/article/view/54885

Aliakbari, F, Parvin, N, Heidari, M. and Haghani, F 2015, ‘Learning theories application in nursing education’, Journal of Education and Health Promotion, vol. 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355834/

Bernard, R.O. 2019, ‘Nurse educators teaching through the lens of transformative learning theory’, Journal of Nursing Education, vol.58, no.4, pp.225-228. https://www.healio.com/nursing/journals/jne/2019-4-58-4/%7B1e963edf-d94e-495b-9af1-5c416e286462%7D/nurse-educators-teaching-through-the-lens-of-transformative-learning-theory

Gandhi, M & Mukherji, P. 2020, ‘ Learning Theories’, StatPearls. https://www.statpearls.com/articlelibrary/viewarticle/24144/

Johnson, BK 2020, ‘Observational Experiential Learning: Theoretical support for observer roles in health care simulation’, Journal of Nursing Education, vol.59, no.1, pp.7-14. https://www.sciencedirect.com/science/article/pii/S1471595317302342

Kardong-Edgren, S, Oermann, M.H. & Rizzolo, M.A, 2019, ‘Emerging theories influencing the teaching of clinical nursing skills’, The Journal of Continuing Education in Nursing, vol. 50, no.6, pp.257-262. https://www.sciencedirect.com/science/article/pii/S147159531202342

Keating, S B & DeBoor, S. S. (Eds.), 2017, ‘Curriculum development and evaluation in nursing education’, Springer Publishing Company. https://books.google.com/books?hl=en&lr=&id=R3QkDwAAQBAJ&oi=fnd&pg=PP1&dq=learning+theories+in+nursing+&ots=A6p3fTDEEx&sig=ifALc8tRC_mWgC6qXgNLLATcIEU

Kelly, A, Berragan, E, Husebø, S E & Orr, F, 2016, ‘Simulation in nursing education—International perspectives and contemporary scope of practice’, Journal of Nursing Scholarship, 48(3), pp. 312-321. https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/jnu.12208

Lavoie, P, Michaud, C, Bélisle, M, Boyer, L, Gosselin, E, Grondin, M. and Pepin, J, 2018,’ ‘Learning theories and tools for the assessment of core nursing competencies in simulation: A theoretical review’, Journal of Advanced Nursing, vol.74, no. 2, pp. 239-250. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.13416

Mahendran, R, Lim, H.M.A & Kua, EH, 2019, ‘Medical students' experiences in learning the Mental State Examination with standardized patients’, Asia‐Pacific Psychiatry, vol.11, no.4, pp. 12360. https://onlinelibrary.wiley.com/doi/abs/10.1111/appy.12360

Männistö, M, Mikkonen, K, Kuivila, HM, Virtanen, M, Kyngäs, H & Kääriäinen, M, 2020, ‘Digital collaborative learning in nursing education: A systematic review’, Scandinavian Journal of Caring Sciences, vol.34, no.2, pp.280-292. https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12743

Mukhalalati, BA & Taylor, A, 2019, ‘Adult learning theories in context: A quick guide for healthcare professional educators’, Journal of Medical Education and Curricular Development, vol. 6, pp. 23. https://journals.sagepub.com/doi/abs/10.1177/2382120519840332

Murdoch, NL, Epp, S & Vinek, J, 2017,’ Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review’, Journal of Interprofessional Care, vol. 31, no.6, pp. 744-753. https://www.tandfonline.co./doi/abs/10.1080/13561820.2017.1356807

Ryan, J, Woods, RL, Britt, C, Murray, AM, Shah, RC, Reid, CM, Kirpach, B, Wolfe, RS, Nelson, MR, Lockery, JE & Orchard, SG, 2019, ‘Normative performance of healthy older individuals on the Modified Mini-Mental State (3MS) examination according to ethno-racial group, gender, age, and education level’, The Clinical Neuropsychologist, vol.33, no.4, pp.779-797. https://www.tandfonline.com/doi/abs/10.1080/13854046.2018.1488996

Stoffels, M, Peerdeman, S. M, Daelmans, HE, Ket, JC & Kusurkar, RA 2019, ‘How do undergraduate nursing students learn in the hospital setting? A scoping review of conceptualisations, operationalisations and learning activities’, BMJ Open, vol.9, no.12, pp. 556. https://bmjopen.bmj.com/content/9/12/e029397.abstract

Yancey, NR, 2019, ‘Evidence-Based practice in nursing for teaching-learning: But is it really nursing?’, Nursing Science Quarterly, vol.32, no.1, pp.25-28. https://journals.sagepub.com/doi/abs/10.1177/0894318418807929

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