Clinical Learning Report: Clinical Learning and Development

This report delves into the significance of clinical learning, emphasizing its role in medical education and the development of crucial skills like clinical reasoning and professionalism. It highlights the challenges within clinical environments, such as time constraints and resource limitations, while focusing on the application of behavioral learning theory. The report explores how behavioral theory, with its emphasis on observable behaviors and conditioning, can be used to facilitate learning among nurses and students. It discusses the use of reinforcement techniques, both positive and negative, to shape desired behaviors and improve the learning process within the clinical environment. The report also examines practical applications of behavioral theory, including respondent and operant conditioning, and provides recommendations for teachers to create effective learning environments that promote positive responses and enhance the overall learning experience.

Running Head: Clinical Learning 1
Facilitation and Education Skills for Practice Development

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Contents
Introduction......................................................................................................................................3
Learning theory................................................................................................................................3
Behavioral learning theory...........................................................................................................4
Use of behavioral theory in nursing.................................................................................................5
Applying behavioral theory in clinical environment...................................................................6
Conclusion.......................................................................................................................................8
References........................................................................................................................................8

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Introduction
Clinical teaching is basically teaching and learning focused on the involvement of the
patients and their problems directly. Clinical teaching is the heart of medical education. In
current time, medical schools are trying to give as much clinical exposure as possible to the
students. In the course, medical schools are focused on providing effective nursing and clinical
experience to the students. Learning in the clinical environment has various strengths. It is
basically focused on the accurate problems in the context of professional practices. Learners in
this environment are motivated by its significance and by active participation (Polit and Beck,
2013). In the clinical learning, professional behavior, thinking, and attitude are developed by the
teachers. Learning in the clinical environment is the setting in which the skills of physical
examination, decision making, empathy, clinical reasoning and professionalism are developed in
the students. Despite of strengths, there are some challenges with the clinical teaching i.e. lack of
clear objectives and expectations, time pressure, competing demands, increased number of
students, often under-resourced and fewer patients. This report focuses on the learning theory of
the clinical environment and role of that theory in the clinical learning practices. Further, report
focuses on facilitating the learning of nurses within the clinical environment that will assist in the
development of culture of learning (Yazdannik, Yekta, and Soltani, 2012).
Learning theory
The educational psychology researchers have done research on learning from different
viewpoints and explained the learning process based on various theories. There are different
theories which can be used as the guide of teaching-learning process learning theories basically
have great use in not only education but also psychology counseling. The learning theories can
be used single or separated or in combination in the clinical education including nursing.
There is the need of learning theory in the clinical environment for the clear
understanding of educational activities, management, interaction with the clients and patients,
health promotion programs and continuous education in the current healthcare structure. in many
institutes, nurses are responsible for the implementation, design and procedures to promote
health training. Learning theories can be used separately, group-wise or at the community level.

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It can be used not only for understanding and learning new things but also for changing health
habits, problem solving control emotions, affecting behavior development and constructive
communication. For the discussion, report focuses on the behavioral learning theory in the
clinical environment. This learning theory is the most beneficial when the change is the desired
outcome of an educational involvement (Haghani & Masoomi 2010).
Behavioral learning theory
Behaviorism is the most dominant approach for the psychology researchers. Traditional
behaviorists perceived that continuous learning depends upon the observable behavior and it is
possible with the communication between two events i.e. a stimulus and a response. In the
simple words, researchers believe that behaviorist learning theory has made its unique way in the
medical education. According to the Bastable (2008), while dealing with people, behavioral
learning theory views the learning process as the simple cycle or chain. Behavioral learning
theory basically focuses on the observable stimulus conditions and the learning process
associated with this. For improve the learning process and getting desired results, learners can
deeply observe and control the environment by using operant condition techniques in the positive
or negative manner.
Currently, in the clinical education, behavioral learning theory is mostly used in the
combination with other learning theories i.e. cognitive theory. In the behavioral learning theory,
teachers continue to be considered important in the nursing practices to achieve high level of
delivery of health care services. For encouraging and motivating people to learn new information
or to change the behavior, responses and attitude, behaviorists recommend to change the
conditions in the environment and focus on the positive behavior. Motivation can be described as
the desire to achieve something or reduce some drives i.e. desire for food, recognition, safety or
money. That is the reason the person who is satisfied or has what he wants, need little motivation
to learn new information, behavior or change old behavior (Guey, Cheng, Shibata, 2010).
Behavioral learning assumes that the learning can take place when the changes in the
behavior can be seen. The behavioral learning model is the effect of conditioning. Along with
this, reinforcement is the key concept of the behavioral learning theory. Continuous
reinforcement is crucial in each case of desirable behavior when the behavior is introduced. In
this theory, it is stated that desired behavior should be rewarded immediately and undesired

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behavior should not be rewarded. This is the crucial term for getting success in the learning
process. Nursing is focused on providing support in each step of the learning process. For
instance, while a patient is learning about injecting the process of insulin, nurse shoes positive
behavior and gives immediate support to the patient by his or her words (Daley & Torre, 2010).
Use of behavioral theory in nursing
Behavioral learning theory is applied in the clinical education or nursing. This theory has
important role in the clinical learning process for the students. Students in the clinical learning
has to deal with number of different points which need various combined forces. So, behavioral
learning theory is more than to be scientific theory of learning including the set of techniques and
principles which can be used in various fields for managing humans. By supporting the desired
behavior, it is possible for the teachers in the clinical learning to achieve the learning goals. The
conditioning theory in the behavioral approach can be used for the behavior therapy of the
students and nurses in the educational environment of clinic. The behavioral therapy in the
clinical learning process can be used to deal with the psychological problems, behavioral
modification conflicts, methods for improvements, and disorder and criminal behavior. Along
with this, change and modification methods in the behavior techniques are also used to train the
students and implement the change in their social and academic behavior in the educational
environment (Khadjooi & Rostami, 2010).
The behavioral learning theory can be used especially in the teaching clinical skills. In
starting, the initial behaviors of every process are motivated for implementing the process
completely. After that, students are encouraged to analyze, understand and implement the right
process of learning. Motivation and encouragement is crucial and desirable to maintain the
behavioral manners. Along with this, teachers in the clinical learning can teach every process by
providing information to the students before starting the learning procedures. For instance,
teachers can remind them to have expected and appropriate behaviors for achieving desired
results in the learning process. Further, computer programs can also be designed for learning
appropriate methods of patient care along with other methods.
Although this process is quite time consuming but it is stated that favorable results of
students’ behavior can be achieved easily. In the clinical learning process, the results may be

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desirable by the use of behavioral learning theory as it is helpful in achieving pleasing results
such as admiration of classmates and client and satisfaction. In this method or theory, every good
or bad behavior depends upon the understanding of student from favorable or unfavorable
outcomes of behavior. The application of behavioral learning theory in clinical learning is most
crucial part of nursing. In this theory, core principles of the education includes the aim of the
education, combination of contents from simple to complex, providing right answers to the
questions, preparing the students to learn in the positive environment, developing a disciplined
environment for learning and training session, and giving reward to the learners after their
success (Webb, Sniehotta & Michie, 2010). This theory is based on Thorndike law and according
to this law; there will be a strong relationship between the response and stimulus for desired
behavior. Thorndike law is commonly used in the nursing education. In the hospitals, nursing
staff are involved in many cases of nursing students. In this theory, the role of manager or
teacher is manipulating the learning environment, providing support and giving information to
the students. In this theory, the learning environment is improving and stimulating. Role of
behavioral learning theory is most important in clinical learning. The behavioral objectives are
very crucial in the clinical training in nursing as it can be used as the guide for evaluating and
teaching the clinical performance of the students in the learning process (Upham et al, 2009).
Applying behavioral theory in clinical environment
Based on above discussion, it is observed that behavioral learning theory is crucial for the
clinical learning process. By using various conditions of the theory, learning of the nurses can be
facilitated within the clinical environment that will assist in the development of a culture of
learning. Behavioral theory focuses on the directly observed and measured behavior of
individual. For the behaviorists, learning is the product having stimulus conditions and response.
For this theory, learning is acquirement of new behavior by conditioning. By focusing on the
conditionings, teachers will be able to improve learning process. There are two types of
conditioning i.e. respondent conditioning and operant conditioning (Wood, Hutchinson &
Cantillon, 2003).
Respondent conditioning-
In this theory, a natural incentive is combined with the unlearned stimulus along with the
unconditional response. After such pairings, natural stimulus extracts with the same response.

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For instance, a person without any kind of experience of hospitals visiting to a sick friend may
feel uneasy and disgusted and in future visit, he may feel anxiety. Sometimes, without thinking
visitors and patients establish connection with their behavior as the result of hospital experience.
Operant conditioning-
This condition basically focuses on the particular behavior of the person and the support
occurs after the response. A support is applied after the response that improves and strengthens
the possibility that the positive response will be performed again. By focusing on some factors
i.e. hugs, praise, prizes and money as the positive reinforcement, the learning process in the
clinical environment can be improved. When the specific responses are supported within proper
schedule, positive behavior can be improved. To improve the possibility of positive, it is
important to apply positive rewards and supports after the behavior occurs. For instance, if a
patient is trying to get up and walk for the first time after an operation, encouragement and praise
for that patient’s efforts will improve his or her continuous struggle towards independence
(Quinn, 2007).
In the behavioral theory, decreasing a negative response or behavior it is important to use
punishment or non-reinforcement in the learning process. To get rid of a negative behavior, then
best way is not to provide any kind of support for some unwanted actions. The behaviorist theory
is easy and simple to use. There should be the requirement of careful analysis of the actions in
the clinical environment that impact the behavior of people during the learning process. Theory
focuses on the reward and support and promotes the value of each person. By applying basic
principles of the behaviorist theory, the learning process in the clinical environment can be
improved:
 Teachers should focus on the drives of the learners along with the external factors in the
environment that impact learning capacity of the learners. Teachers should also focus on
the reinforcements to improve the positive responses.
 The objective of the teacher should be to analyze the conditions of the environment that
lead to specific behaviors. He must analyze the past history and habits of the learners.
After that teacher must manipulate the conditions effectively to provide right support, to

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build new connections and to improve positive behavior or response of the person
(Rahmani, et al, 2009).
Conclusion
From the above discussion, it is observed that various learning theories have important
role in the learning process of clinical environment. Effective learning is the result of good
teaching. It can be improved by the learning environment including active communication and
interaction among the students, faculty and student peers. Effective learning in the clinical
environment can be achieved by the use creative strategies and learning theories to inform and
stimulate to the students. For the effective learning process, faculty and teachers should identify
the students as individuals by the personal ways of learning and knowing them. Along with this,
by developing learning situations for the students, faculty will be able to recognize diversity and
improve their capabilities to think in the new way.

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References
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literature review, Med Educ., 44, 440–8
Guey C. C., Cheng Y.Y., Shibata S., (2010), A triarchal instruction model: Integration of
principles from Behaviorism, Cognitivism, and Humanism. Procedia Soc Behav Sci., 9, 105–18
Haghani F., & Masoomi R., (2010), Overview of learning theories and its applications in
medical education, Iran J Med Education, 10, 1188–97
Khadjooi, K., & Rostami, K., (2010), The implications of Behaviorism and Humanism theories
in medical education: Research Institute for Gastroenterology and Liver Diseases, 3(2), 65-70
Polit, D. F., and Beck, C. T, (2013), Essentials of Nursing Research: Appraising Evidence for
Nursing Practice, USA: Lippincott Williams & Wilkins, Philadelphia, Pa,
Quinn, F. M., (2007), Principles and practice of nurse education, (5th), London: Nelson Thornes,
pp. 15–21
Rahmani A, Mohajjelaghdam A, Fathiazar E, & Roshangar F., (2009), The effect of adapted
model of mastery learning on cognitive and practical learning of nursing students, Iran J Med
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