Approaches to
student centered
learning for health
professionals
Florence F. Adhiambo
Hawa
MPH.KRCHN.KRM.KRN

Introduction
Learning produces a relatively permanent change in the behavior and way of thinking of the
learner as a result of positive or negative experiences. The change is gradual, adoptable,
abstract and selective. It may be observed and noticed after a period of time
This means that, there are activities a learner needs to do in order to gain the change eg,
listen , read, talk to each other, observe activities, watch a practical demonstration and
perform according to instructions. There should be , repetition, feedback and evaluation
Health care professionals are responsible for designing , implementing and evaluating
patient and client centered care and treatment plans for health education and wellness.

Learner centered learning
Health care professionals interact with clients and patients who have high expectations . The challenge in teaching is to identify
the clients ways of perceiving and processing information influenced by their social background,
In these slides the objective is to develop learner autonomy, independence and responsibility for their own learning in order to
achieve set educational goals
While socializing within the family most learning is through oral narrative and observation from the older generations. Formal
learning is done in schools including reading , writing and arithmetic as the child grows up
We look at the various principles ,theories and conditions of learning with the aim of encouraging student centered learning
which is lifelong . Theories explain how and why people learn. The health care professional must apply evidence based learning
theories in education and training of clients, patients and staff
Various participatory learning methods are explored such small group discussion and skill based interaction
Learning should bring an observable change in ones emotions, functioning, feelings and skills

Principles of learning
Principles- are rules , laws or facts and arise as a result of repeated experience, leading to a deeper
understanding of ideas on the processes of teaching and learning
Students learn :
 what is relevant and useful
 when the material is presented in a logical sequential order with progression
 when they are actively involved
 when they receive feedback on their performance

Principles of learning
 Individual pace of the learner should be appreciated
 Learning should be for understanding and application of knowledge
 The learner must have Interest for learning the subject
 The learner should be open minded , reflective and think critically
 There should be respect for teachers and students

What are the main teaching methods?
• Teacher-centered methods may include force-feeding prescribed knowledge
• Learner/ student -centered methods examples are problem based tutorial, small group
discussion and skill acquisition

Function of theories in teaching and
learning within health care
Theories:
 provide a basis or logical framework to understand how people learn and a way to explain,
describe, analyze and predict outcomes
 helps us make more informed decisions with clear rationale on the design, development and
delivery of learning
 help to organize relevant observed or measurable facts in order to create a context for
understanding phenomena.
Health care workers can apply learning theories at the individual , group and community level to
understand and teach new materials and tasks, solve problems, change unhealthy habits, manage
emotions and encourage positive behaviours.

Theories of teaching and learning
The following are most often applied to patient/ client education , since they encourage a patient
centered approach to care
They can be classified into :
 Cognitive Learning Theory
 Behaviorism Learning Theory
 Constructivism Learning Theory
 Humanism Learning Theory
 Social learning theory

Cognitive theories
Cognitive theorists believe that knowledge is a mental process that results in
one being aware of a situation and reorganizes his thinking to a new
understanding.
B.S Bloom proposed 3 main domains of learning
 Affective domain- concerned with attitudes
 Cognitive domain concerned with knowledge
 Psychomotor domain concerned with muscular and mental activities (skills)
According to Bloom, there are levels of learning a learner must go through
starting from basic existing knowledge to the highest level possible

Cognitive theorists
D.P. Asubel – proposed that learning should start from known to unknown: simple to complex. He noted that new
information fits into existing knowledge .To remember one must think or act on the new information
J. Brunner
Recommended Problem Based learning where a teacher provides problem for the learner to work out the
answers on their own and resources with which they must do so. This innovative learning reminds the learner that
he can learn if he wants to do so.

Problem based student centered learning
The PBL process was pioneered by Barrows and Tamblyn at the McMaster University medical school in Hamilton,
Canada in the year1969. Complex real-world problems are used to promote student learning of concepts .
The 3 steps PBL tutorial
Step 1- students read through problem, define terms, clarify concept, analyse the problem and set learning
objectives. Students identify their own learning objectives (SOLO)
Step 2- The student studies and looks for information on their own, Give a time frame
Step 3- Presentation of gathered information ,solution of problems and synthesis

Behaviorist theorists
They observe a persons response to stimuli and the environment
 R . M. Gagne- categorized learning into different domains. Motor, verbal and intellectual skill . Another
domain is cognitive strategies and attitudes He insisted that skills cannot be learned unless students
were given opportunities to practice under supervision
 Edward Thorndike- looked at learning objectives to direct goals
 Ivan Pavlov- studied conditioning reflex, punishment and reinforcement
 John Watson- encouraged active participation i.e. learning by practice

Constructivism Theory
 It says that learners construct knowledge rather than just passively taking in information.
 As one socializes and reflects upon those experiences, they build their own representations and
incorporate new information into their pre-existing knowledge (schemas).It is important to give a patient
facts concerning their disease condition to dispel myths
 Main Theorists are John Dewey (1933/1998) , Bruner (1990) and Piaget (1972) and Vygotsky (1978) .

Humanistic theories
 The humanistic model of nursing looks at the patient as an individual, and each situation as unique. It explains
the five levels of nursing practice , which are: novice, advanced beginner, competent, proficient, and expert
 Practice of skills is a process of reflection focusing on synthesis and application of knowledge and
experiences of the nurse or caregiver ,that are deliberately and consciously constructed
 Emotional reactions to situations such as pain ,are learned as a result of experience. They are considered
when dealing with health, disease conditions, medical treatment, convalescence, prevention of relapse and
defaulters of treatment.

Abraham Maslow humanist and
psychologist
 He observed that traditional teaching and learning has concentrated on rote learning of
facts, theories and formulas and has neglected to encourage the development of the
student as a person with a role in society.
 According to Maslow, education should help students to look within themselves, and
from this self knowledge, develop a set of values which will guide them in their life of
work.
 He emphasizes the importance of learning for self enhancement rather than simply for
utility.
 The individual should be helped in deciding what to learn and how to learn it
.

The Learning atmosphere
 Should be conducive and encourages people to be active
 Emphasizes the personal nature of learning
 Accepts that differences is desirable
 Recognizes proper rights to make mistakes
 Tolerates imperfection
 Encourages openness of mind and trust in self
 Makes the individual feel respected and accepted
 Facilitates discovery
 Puts emphasis on self evaluation and co operation
 Permits asking questions and brainstorming

student-centered
learning
 refers to a wide variety of educational
programs, learning experiences,
instructional approaches,
and academic-support
strategies whose goal is to address the
specific learning needs, interests,
aspirations, or cultural backgrounds of
individual learners .

Advantages of student centered learning
 Teachers and students create a learner-centered environment
 Teachers act as both facilitators and activators
 Students assume responsibility for goal setting as well as attaining proficiency on
learning targets
 Students generate evidence of mastery of content, state, national, and international
standards
 Curriculum is organized into individual learning targets/ modules which are systematic
 Students are able to communicate their progress relative to personalized learning goals
 Instruction strategies match individual student’s needs to improve student performance
instruction , assessments and evaluation are linked

Humanistic and social psychologist-
Carl Rogers
He advocated for learner centered view of learning and believed that :
 All humans have a natural potential and desire to learn
 Learning occurs when the student perceives relevance related to his own purposes and learns
through doing
 The learner is responsible for choosing his direction , discover resources, and formulating problems
He contributed to use of small group discussion , where the teachers is a guide and a friend rather
than leader.

Small group discussion
It is a popular and effective teaching technique for encouraging
learners to analyze , synthesize and evaluate the knowledge
that they acquire e.g. causes of a disease or harmful customs
practiced within a community
A group should be small enough for all members to see and hear
each other without difficulty. A group of more than 12 is likely to
be too large, 5-12 members is ideal.
Groups undergo stages of formation, growth, development and
maturation

Advantages of small group discussion
 There is shared commitment to learning. Learners help each other with difficult points
 Provides learner with opportunities to interact with the instructor and fellow learners
 Learners learn to evaluate evidence
 They learn self expression and intercommunication
 They become active participant . Work becomes a motivation to the learner.
 The student grasps the idea of self learning without fear of failure.

Disadvantages of small group discussion
 Dominance of vocal and aggressive members
 Extended length of time during discussions
 Discussions could loose direction
 Poor planning due to lack of agenda and specific learning objectives leading to waste of time
 A big group has less interaction
Physical environment eg a small room with inadequate furniture and poor ventilation
social environment such as difference in age and hostility

How to be a useful group member
 Accept responsibility, do not blame others
 Listen to what others say rather than just waiting for an opportunity to attack
 Think and relax before jumping to conclusions
 Be flexible.
 Think of how your group can succeed
 Control disruptive elements

Albert Banduras Social learning theory
 He asserts that most human behavior is learned through observation, imitation, and modeling.it
recognizes a difference between acquisition and performance of learned behaviour such as
during teaching and learning of skills
 This theory can help students reach their potential. Students imitate each other and also the
teacher who should be a good role model and an expert at the specific skill.
 The effect or change in behavior is evaluated by observing the positive and negative
consequences that follow
 In everyday life family members, friends, famous actors in the film industry are imitated if there
is a reward . Changing unhealthy behavior can be done through correcting distorted
explanations and opinions regarding ones illness
These theory can be applied to change peoples views refer to
https://www.slideshare.net/FlorenceobonyoHawa/change-management-kotter-and-lewin

Teaching psychomotor Skills
• Step 1 Teach the theory and rationale of the skill
Step 2 Do role modelling -Demonstrate the procedure such as how to give an injection using
the ideal equipment
• Step 3 Provide systematic instruction as you do the practical
• Step 4 Rehearse and discuss the main points to enable comprehension and
understanding
• Step 5 Supervise the Practice. The learner should do a return demonstration and repeat a
set number of times until each gains mastery.strengthening the habit
• Step 6 Proficiency –here the learner acquires expertise, evaluation and feedback must be
given

To achieve lifelong learning
 The learner needs :
 Motivation
 Information
 Resources
 Encouragement and guidance
 Active participation
 Practice of skills and
 Feedback