Developing mentors to support students in practice, Part 4: Facilitation of learning

Summary

Following on from the last article that looked at the importance of creating an effective

learning environment this article will set the context for the facilitation of learning. This will

start by first visiting some of the key principles and theories for understanding and describing

the process of learning. Examples will be provided to link these concepts to practice but the

more practical aspects of utilising these theories in a practice setting will be discussed in the

fifth article ‘Developing mentor and practice teachers to support student in practice, Part 4:

Facilitation of Learning. Together these Articles will provide mentors and practice teachers

with a firm grounding and understanding of the learning process. This will then enable them

to meet the requirements of standard 3 ‘Facilitation of Learning’ set out in the Nursing and

Midwifery Council (NMC (2008) ‘Standards for Supporting Learning and Assessment in

Practice’ (SSLAP). These are highlighted in box 1 below for both Mentors and Practice

Teachers respectively.

Introduction

It can very easily be argued that the central feature of mentorship, is learning. More

specifically; how it is undertaken, what promotes it, what detracts from it and how it is

managed. The use of the word learning here is very deliberate and this word will be used

throughout this article given that the focus will be upon how people learn, not necessarily on

how they are taught. This dichotomy of language is an often-discussed topic within the

literature. The general basis of this argument is that engaging in the act of teaching does not

necessarily mean that someone is learning something (Robinson 2013). Likewise, it can be

feasibly argued that learning does not necessarily require direct tuition. Thus the emphasis

within mentorship is on the facilitation of learning not of the teaching of nursing skills. Its

feasible to assume some amount of teaching may take place, but this would be but one aspect

of the facilitation process.

At face value learning appears to be a fairly straightforward concept, it is something everyone

does every day and all human beings have a long history of engaging in it. Its complexity is

revealed however when people are asked to define it, this is when the rich and diverse

variation of ideas comes out. This is because learning is a very multifaceted process that

requires an appreciation of many different factors in order to understand it (Gardner 2012)

and this is very much reflected in the ever-evolving understanding of how people learn. This

presents a particular challenge for mentors as they are faced with the need to find ways to

promote meaningful learning opportunities for their students.

The theories and concepts discussed below are rooted in the social sciences; initially

psychology but many of the later theories also incorporate strong sociological influences as

well. Each has its own features that separate it from the other theories yet many ideas and

concepts are shared between them. Along with this, each has its own strengths and

weaknesses and consequently individuals will have differing levels of affinity towards them.

Mentors and practice teachers should seek to develop a clear understanding of the different

theories of learning and avoid a tendency towards adhering to a single one (Gaberson et al.

2015). This will enable them to be adaptive in their facilitation of learning for different

individuals and in different circumstances. In addition to this it provides a wide repertoire of

knowledge with which to review and analyse the process of learning, particularly in new

situations or instances where students are struggling. This comprehensive analysis will then

provide a good starting point from which the mentor and practice teacher can devise a plan of

how to better support learning.

Before continuing it is worth noting at this point that these theories need not be mutually

exclusive. Whilst they are born out of very different assumptions and worldviews they can

be complimentary to each other. The different theories of learning did not evolve from each

other in a clear chronology. Instead they developed over time, in some cases and extended

period of time, along side each other, often cross-pollinating each other. Skilful and

experienced mentors/practice teachers will use a combination of theories in order to create a

very rich and engaging learning experience that challenges different aspects of a student’s

abilities.

Behaviourism

One of the earliest theories of learning is that of Behaviourism. This theory dates back to the

beginning of the 20th century and the work or researchers such as John Watson, Burrhus

Skinner and Ivan Pavlov (Kellogg, 2002). Behaviourism is very objective in its nature and

seeks to only analysis that which is readily observable, such as people’s behaviours and any

changes in those behaviours that result from some kind of stimulus or response (Skinner

1969). Within this theory individuals become conditioned to either avoid or repeat particular

actions, habits or activities based on the response they receive. The emphasis here is on the

feedback received in response to the actions or behaviours performed and whether or not this

promotes repetition of those initial actions or behaviours. This theory has no concern with

what thought processes might be going on in relation to behaviours performed or the

feedback received. It is only concerned with whether or not a particular action receives a

positive response, such as a reward, then they are more likely to repeat that action.

Conversely, if an action elicits a punishment or some other kind of negative response, then

they are less likely to repeat that action again.

The apparent simplicity of the behaviourist theory of learning can hide its usefulness in both

managing learning and diagnosing problems with learning and or behaviour in general

(Miltenberger 2012). There are two main models that could be considered key in

understanding learning within the mentorship context. Firstly there is ‘Classical

Conditioning’ which was a model developed by Ivan Pavlov (Pavlov 1960) who undertook

experiments to see if he could cause dogs to exhibit a physiological response to an associated

and natural external stimulus. In these experiments he would ring a bell each time a dog was

fed. Overtime the dogs linked the sound of the bell to the expectation of food. Thus after

repeated reinforcement in the form of rewards, the dogs would salivate as if anticipating food

at the ring of a bell. The important aspect of this association is that it is formed in the

prescience of a neutral factor that does not itself elicit any kind of response but becomes

perceived as such.

What this demonstrates is that the repeated presence of a neutral factor (the bell) when an

individual is experiencing some kind of stimulus, be that positive or negative can result in an

association being made. This association can then lead to a physical or emotional response

from just the presence of the neutral factor (Pavlov 1960). Within the theory of classical

conditioning mentors and practice teachers would not be setting out to intentionally create

these associations between a stimulus and neutral factor that falls under operant conditioning

which will be discussed shortly. Instead, it is likely that such individuals may notice such

reinforcement occurring naturally and chose to pick up on this and further reinforce such

behaviour. This could be where learners are seeking out particular opportunities (such as

talking to patients) because of the enjoyment (engagement from patients) they derive from

them or conversely, avoiding them because of previously troubling results (awkward silence

or unwelcomed questions).

Another very popular model within behaviourism is that of Operant Conditioning which was

first explored by Burrhus Skinner (Skinner 1969). Within this model behaviour is

deliberately conditioned through the application of different types of reinforcement in

response to the exhibited behaviour (Skinner 1969). The most commonly held view of this

model is the application of either a positive or negative stimulus in order to encourage or

discourage repetition of that behaviour (Kinnell & Hughes 2010). So the exhibition of good

behaviours are encouraged through some kind of positive reward, which in Skinners

experiments would have been a highly desired food item. Unwanted behaviour would be

discouraged by either punishment, or the withholding of the positive reward, thus this is

considered to be negative reinforcement (Kinnell & Hughes 2010). In Skinners original work

however he broke these down into four categories: - positive, negative, no reinforcement and

punishment. In his original work negative reinforcement was distinct from punishment and it

was mainly a technique applied by the learner to make situations more bearable and avoid

detriment to themselves (Skinner 1969).

It’s fairly easy to see how Skinners Operant Conditioning fits into the context of mentoring.

Mentors and practice teachers will be observing a student’s behaviour and performance with

a view to either reinforcing or discouraging particular aspects of that behaviour. As noted

above, this is where the simplicity of behaviourism can be very deceiving to Mentors and

practice teachers and there are several pit falls that people may succumb too. There is often

an assumption made that providing punishment of and undesirable behaviour increased the

likelihood of the desirable behaviour being performed in future (Butts & Rich 2014). This

may be the case in some instances but it is not a universal principle. A learner who is

chastised for not having enough knowledge of a particular subject does not necessarily go and

learn more about it. They may instead find way to avoid working with the person who

Learning activity 1. Reflection Point – Consider the behaviourist learning

theories discussed above in the context of clinical practice. Make a list of all the

different aspects of your role, such as the skills, knowledge and attitudes required

to undertake your nursing role. How easy would it be to facilitate the learners

development of these different aspects using the principles of operant

conditioning discussed above? What are the factors that would make the use of

operant conditioning difficult for some aspects?

provided the chastisement in the first place (an example of negative reinforcement). Truancy

in school is another good example of this kind of avoidance behaviour.

It is for the reasons noted above that the provision of a positive stimulus (e.g. praise or

reward) to the desired behaviour is more powerful (Butts & Rich 2014; Killgallon 2012).

There is a much clearer link between the reward and the desired behaviour and this makes it

easier for the learner to then repeat the behaviour that instigated the reward in the first place.

Mentors and practice teachers need to be mindful however that positive stimuli work equally

well for encouraging the repetition of undesirable behaviour as well as desirable behaviour.

This is because it is recipient of the stimulus who essentially decides if it was pleasant or

unpleasant, thus reward or punishment. For example a student may find that by cutting

corners and rushing particular aspects of their roles they can get them completed quicker.

This in turn gives them more time to engage in the activities they enjoy as well as getting

them praise from their mentor or practice teacher. Thus positively reinforcing the behaviour

or rushing

their

work

and

cutting

corners.

Now

complete Learning Activity 1.

Social Learning Theory

The ability to learn from the action and response scenarios of behaviourism are not tied

exclusively to the individual’s own interactions in the world. Albert Bandura (Bandura 1977)

developed a Social Learning Theory that described how individuals can observe the outcomes

achieved by the actions of others in order to decide if this is behaviour they would want to

emulate. He undertook a very famous series of experiments with children in which different

groups of children observed an actor in a playroom. Some groups would see the actor being

aggressive towards a Bobo doll (large inflatable clown) and other would see the actor only

playing with the doll. Those who had witnessed the aggressive behaviour were more likely to

exhibit the same behaviour. Equally, if the children saw the actor receiving punishment for

their aggressive behaviour, they would be discouraged from enacting it themselves for the

fear of the same outcome.

This has pretty serious and significant implications from the clinical learning perspective that

mentors and practice teachers need to be very mindful of. It demonstrates that learners in a

clinical environment are likely to look at the practice of those around them as a guide for how

they need to act (Klunkin et al. 2011). This is not to say that every practice witnessed will be

mirrored by the learner or that bad practice will be mirrored with equal likelihood. That

would be an oversimplification of the theory. Instead, learners will first enter what is termed

the ‘attentional’ phase, whereby they decide whose actions they should be paying attention

to, or rather who are the role models. The decision is often influence by the status of the

potential role model in terms of standing, grade, seniority, number of other followers etc

(Bandura 1977). This process is particularly powerful in helping learning to pick up

skills/behaviours that they think they may need in the future, but have had little or now

opportunity to develop; such as communication skills in different situations, or handling

complex and challenging situations. Identifying a suitable role model does not necessarily

mean their behaviours will be copied, the learner has to progress through the stage of

‘retention’, ‘reproduction’ and ‘motivation’.

Learning activity 2. Reflection Point – Think now about Bandura’s social

learning theory and the chances that students may emulate the behaviour of more

senior nurses. Think about intentional and unintentional role modelling. In

unintentional role modelling the nurse demonstrates something that isn’t best

practice, but perhaps ‘gets the job done’. It is unwitting behaviour. In intentional

role modelling the nurse demonstrates behaviour that meets best professional

standards as well as being effective. It is designed to help students learn. What

do you think this means for your role modelling before the student? Do you have

a part to play helping students to evaluate unintentional role modelling seen in

others?

In the ‘retention’ phase the learning will observe closely the behaviours and outcomes and

store them for later use. They will then start to practice these behaviours during the

‘reproduction’ phase. The purpose of this is twofold; firstly it is to gain a degree of skill or

expertise the behaviours they are modelling. Secondly, it is to see if they get the same kind

of results or feedback as the role model. This is a very key phase for mentors and practice

teachers to be aware of since their reinforcement or lack of it here will influence how likely

they are to continue those behaviours. This then progresses into the ‘motivation’ phase

where the individual will decide if they have the motivation to continue those practices based

on their expertise at them, and the response they have gained.

Whilst it is very important to recognise and reinforce the desired behaviours, at this stage, it

is also important to look for undesirable behaviours. The learner will not only be basing their

motivation of whether or not to repeat on the presence or lack of reinforcement, but they will

also be basing it on the overall gains. So if an undesirable behaviour enables them to

complete a task or role they don’t like more quickly and it is neither reinforced nor

discouraged, then they may be more likely to repeat that behaviour again. Even a mild

reprimand may still be considered worthwhile if the overall gain is more gratifying to the

learner. As noted with regards to operant conditioning above, a more powerful approach

here would be to reward the correct behaviour since severe punishment of the undesirable

behaviour may entice the learner into developing ways to hide it. In addition to this, the

mentor or practice teacher can be pivotal in helping the learner make sense of the how and

why in relation to the success or failure of particular actions or behaviours. Now complete

learning activity 2.

Cognitive Theories of Learning

As effective as behaviourist approaches can be in the delivery of learning, they do have

significant limitations. Much of the original research undertaken to develop the behaviourist

theories was undertaken with animals and at a time when there was very little understanding

of neural functioning. As a result they do not overly concern themselves with what the

learner may be thinking, or what impact things like mood, motivation or social context might

have on learning (Butts & Rich 2014). In particular there was no adequate explanation for

how people would apply learning gained in one situation to another distinctly different

scenario. This is a challenge students are faced with all the time in clinical practice. They

may develop a degree of skill in providing care for a patient within their own home, but what

processes enable them to bring these skills to the resuscitation room of a busy accident and

emergency department?

More importantly perhaps is why the student developed skills in providing care in the first

place. It would be discouraging to believe that these skills developed solely out of a need to

gain praise and reward from their mentors and practice teachers. Instead it is more likely to

be something more internal and introspective on the part of the learner. Nursing care may

carry an intrinsic reward, a personal feel good factor associated with care well delivered. It

can easily be argued that the learner gained positive re-enforcement in the form of the

feelings of accomplishment and/or pride they gained from providing good care. This positive

re-enforcement from providing such care may be significantly delayed and/or require the

sequencing of less rewarding activities to get to the end result. Behaviourist theories of

learning focus on a much more immediate and obvious reward of ones actions. It was

questions and shortfalls in explanation such as this that lead to the creation of the cognitive

school of thinking upon which the majority of modern psychology is based (Kellogg 2002).

Like the behaviourist theories that came before them, cognitive learning theories started out

based on experimentation and observation of animals. The difference was that cognitive

theorists placed a greater emphasis on exploring some of the less observable factors such as

the role of memory, abstract thinking and how information from the environment is processed

(Kellogg 2002). One of the key realisations gained from this school of thought was that

learning does not have to centre on actions and the resulting effects of those actions in a real

world situation. People are able to use their imagination to conceptualise and plan out

different scenarios and how they may turn out based on different courses of action. This is

often referred to as Gestalt Thinking (Burn, 2013). By giving precedence to the ability of

people to be able to think through a problem scenario in the abstract sense in order to work

out the best course of action; it provided a clearer explanation of how learning is transferred.

Thus an individual when faced with a problem can recall from memory their experiences of

similar or closely linked problems and consider how that fits within the context of the current

scenario. This then enables them to think through multiple courses of action and how they

may play out before choosing the one they want to implement.

There are a host of different models and concepts within the cognitive theories of learning

umbrella but they all share the same central premise that people are thinking entities capable

of modelling scenarios in an abstract sense. These theories of learning grew out of Gestault

Psychology (Burn 2013) which was a Psychology movement concerned with how memory

and prior knowledge influence learning. More importantly it credited the individual with the

ability construct complex mental representations of the world around them based on their

experiences and interpretations of it. This internal model can then be utilised to test out new

ideas and courses of action in order to select the most desirable approach or response to

utilise in the ‘real’ world.

This was significantly divergent from the behaviourist mode of thinking in that it placed less

focus on the stimulus and response modality of learning. Mentors and Practice Teacher can

play a significant role in this process by enabling students to make sense of these experiences

and reflect on how such experiences can be managed in the future. In some instances this

may be assisting learners to reason what might be likely outcomes or responses. At other

times it may be a matter of ensuring the learning is focusing on the key factors or tenants of a

particular situation or experience that may have been missed. For example a learner who is

attempting to improve upon a previously poor communication experience may have

overlooked the importance of her body language because they have focused on the word

used. A skilful educator may then highlight these factors so that she is then able to add them

to her mental construction of this skill, thus enabling her to consider these issues both in the

abstract sense and when implementing communication in the future.

Learning activity 3 Reflection Point – When someone starts learning to drive and the

instructor asks them to make a right hand turn, their memory is instantly filled with all the

things they need to consider. Gears, mirrors, other traffic, distance to the turn, speed of the

car etc, it takes a great deal of concentration. If they are asked to make a right hand turn a

couple of years after passing their test, they may not even notice what they are thinking

about in order to accomplish the task. All the various things that previously filled their

memory have been combined into one single task.

Consider your developing practice as a health care professional, can you think of any things

that you now do that at one point felt impossibly complicated? Try to break this down into

its component parts, what where the individual steps or aspects you needed to master? If

you were to teach this to a student, how would you structure it so that they did not become

overwhelmed?

The attention paid to memory and its internal representation by the Gestalt psychologists lead

to a number of advancements in the understanding of how it works that have a significant

impact the understanding of learning. Along with the defining of long and short term

memory came a greater understanding of working memory, this place where information that

is currently being mentally manipulated is stored (Baddeley 2012). The details of working

memory are complex and there is significant variation between individuals based on age,

experience and the type of activity being undertaken (to name but a few) (Butts & Rich

2014). The important conclusion that needs to be taken from it however is that it has limited

capacity. The implications of this are that learners are only able to keep so many ‘chunks’ of

information in working memory at any given time. Too many, and they will begin to struggle

and their ability to learn will be very limited (Baddeley 1986). Consequently, managing the

amount in working memory at any given time is a very important activity that mentors and

practice teachers need to manage carefully. By presenting concepts, ideas and skills in

manageable chunks, mentors and practice teachers can help individuals build upon what they

do in a progressive and manageable fashion. Now complete Learning Activity 3.

Experiential Learning Cycle

One of the most widely utilised cognitive theories is that of the ‘Experiential Learning Cycle’

developed by Kolb (Kolb 1984). Within Kolb’s cycle successful learning need to progress

through four distinct phases; Concrete Experience, Reflective Observation, Abstract

Conceptualisation and Active Experimentation. One of the key features of this cycle is the

learner can technically enter the cycle at any point, but in order for successful learning to

occur, they need to progress through all stages. In addition to this, it is iterative with no

defined end point and a cycle can be of vastly varied length. What seems important however

is that the student is helped to understand how they are reasoning and what the value is of

each stage within a cycle. If the learner learns the mechanism of learning, then they can learn

more for themselves. The cycle itself can be utilised as a form of diagnostic checklist by

mentors and practice teachers to help them move students through the different stages and

this may involve making the process very explicit with the learner. This means that learners

can continuously build upon their learning and even explore the consequences of what might

happen in different scenarios or if different approaches had been tried.

Given the focus on reflection in most undergraduate curriculums this cycle links well to what

is expected of the learner and helps to promote patient centred reflection. From a mentoring

perspective it is most likely the students and mentors and practice teachers will enter the

cycle at the ‘concrete experience’ point (the nurse encounters patient upset by bad news).

This is when the learner has had a real life experience deemed to be significant or a point of

focus. From here the learner needs to reflect upon that experience, this can be aided by

mentors and practice teachers asking questions or highlighting key issues that should be

focused on (So what should I have done). The reflection will yield questions or queries that

expose a gap in the learner’s knowledge, or things they need to investigate further (what are

the ways in which I could help). During the abstract conceptualisation phase they will set

about investigating these ideas and formulating alternative courses of action should the event

occur again (I know have a range of tools to attempt should the situation occur again). This

may result in the need to either physically test out some aspects of the new knowledge/idea or

to experiment with them theoretically. Either way, the result of the active experimentation

phase is a clearer understanding of how the situation would be handled in the future. Thus

they are now back to the ‘Concrete Experience’ stage we can itself then instigate another

progression through the cycle.

Despite the comprehensiveness of many cognitive theories of education it is not without its

criticisms. For some there is not enough focus on the social aspects of learning and the way

in which they can promote, hinder or otherwise influence what is learnt and how learning

takes place (Cobb & Bowers 1999). On the ward, students learn as part of a team, where care

problems are solved and strategies developed. In other circumstances it is the

epistemological assumptions upon which many cognitive theories are based that forms the

central criticism. Since many such theories are over half a century old, they share the

predominant viewpoint of knowledge and knowing that was prevalent at the time, positivism

(Fosnot 2005). This particular philosophy promotes the logical and mathematical

interpretation of data in order to create knowledge, disregarding speculation and individual

interpretation. Cognitive theories certainly don’t dismiss speculation, but they do underplay

the interaction of emotions and reasoning, the doubt that exists as a student makes sense (for

example) of their clinical placement. Cognitive theories underplay the complexity of

experiential learning where many events and experiences may have to be summed up to form

a gestalt explanation. Furthermore it is based on the assumption that there is an absolute truth

and the advancement of knowledge is progression towards that single truth, an end point for

which there is no variable interpretation. This very clear-cut viewpoint was at odds with the

emerging philosophy of antipositivisem (or interpretivisem) that contested that in some

things, there was not an absolute truth to be discovered. Instead, there was a need to explore,

investigate and interpret individual actions and truths, articulating in areas of human

interaction or socialisation such as learning.

Constructive & Humanistic Learning Theories

This shift in the way knowledge is viewed gave rise to constructivist theories of learning

which placed a greater emphasis on the individuals experience and interpretation of learning.

Constructivist theories of learning depart from the premise first discussed by Jean Piaget who

noted that acquisition of knowledge should enable individuals to adapt their practices and

behaviours: not to become copies of those instructing them (Fosnot 2005). This is a fairly

organic view of knowledge and its development, and shares its ideological principles closely

with evolution theory. In this respect knowledge is not developing to an end point of

absolute knowing. Instead, knowledge, evolves and develops in order to enable survival, be

that’s physical survival or emotional survival. Indeed, some knowledge is developed in order

to ensure a person’s direct survival, such as what to eat and what not to eat, or how to safely

cross the road. In the new thinking the purpose of learning was not to secure absolute or

perfect knowledge, but knowledge that was workable, that enabled the practitioner to practice

their profession when the situation around them was constantly changing.

From a learning perspective constructivists place a big emphasis on what the learner already

knows and the interpretations they have made of this knowledge (Killgallon 2012). Further

to this, learning is considered to be a nonlinear and highly complex process in which the

learner must navigate and negotiate competing and conflicting experiences. The focus of this

is not necessarily to gain a measurable set of skills, but to have increased the depth and

breadth of personal understanding, thus aiding future interactions. Because of this, models

are few and far between within the constructivist domain, instead it is guided by a clear set of

principles and practices that seek to promote a learners own construction of meaning. In

summarising the basic principles Fosnot (Fosnot 2005) articulates that learning requires a

degree of self-organisation on the part of the learner and as such is a personal process,

separate from that of any instruction given. In addition to this, learners need to be permitted

to construct and test their own knowledge, which may mean making mistakes in order to

learn from them and further refine their understanding. Alongside this, learners need to be

able to reflect on their evolving knowledge and given opportunity to discuss it critically

without fear of reprimand or judgment (Kinnell & Hughes 2010).

The principles described above share many similarities with the experiential learning cycle

described by Kolb; there are opportunities to reflect, test, experience and postulate. The key

difference however, is this is not considered to be a cyclical process within constructivism.

Instead it is much more loose and the learner may jump back and forth between reflecting and

discussing before putting something into practice. For this reason it can be very challenging

for a mentor and practice teacher to facilitate learning using constructivist principles,

particularly in the very risk adverse context of modern healthcare. The need to allow mistake

and errors however should not be interpreted as students being given free rein to potentially

cause harm for the sake of learning. Instead it is more a matter of providing an environment

in which ‘mistakes’ are made conceptually and without the burden of reprimand or negative

judgements.

This freedom of exploration on the part of the learner also requires a greater degree of leeway

with regard to timescales for the completion of particular objectives. A mentor and practice

teacher may have it in mind for a learner to understand the how a particular patient’s care

should be organised. Using non-constructivist principles they may set about discussing and

demonstrating the process and/or setting work for the student to complete. This would have a

fairly tight time frame attached to it, which in some instances might be particularly short and

have a very ‘instructional’ feeling to it. Using more constructivist principles however the

mentor and practice teacher would first need to set about exploring the learners existing

understanding in relation to the circumstances of the patient in question (Gopee 2011). From

this they would then need to help the learner identify areas that they need to further explore

and in some cases this may mean enabling some kind of experience for the learner to further

explore their understanding. Ultimately the student in this scenario would largely dictate the

time scale. This therefore has implications for its practicality within the time constraints of a

practice placement and the need to complete set objectives.

Learning activity 4 Reflection Point – The pace of learning in many clinical areas can be

very fast and learners face enormous challenges to master the skills and knowledge

required. This may lead many mentors and practice teachers to adopt a more instructional

approach by directly providing the information to the students.

Think of some key learning points associated with your clinical area. Consider how you

could facilitate students to explore and make sense of these key areas of learning at their

own pace. What strategies could you deploy to allow the student to link them to their own

experiences? What resources would you need to enable this exploration.

The features of constructivism described above share many of these basic ideologies with what is

broadly termed Humanistic Learning Theory. Humanists place a great deal of emphasis on the

individual’s feelings and emotions; aspects that they felt had previously been ignored by the earlier

theories of learning. Like the constructivists, they also promote the idea of learning being a personal

journey in which the educator is a facilitator not and instructor. As such learning is regarded as a

persons progression towards self-fulfilment and their motivation to learn stems from the desire to self-

improve and explore their own developing understanding of the world (Gopee 2011; Butts & Rich

2014). As with constructivism, this can be somewhat hindered by constraints put on learners within

education programs, such as deadlines, learning outcomes and set knowledge that must be gained.

This is not to say that such approaches cannot be accommodated, it does however, demand greater

skill on the part of the facilitator. Now complete Learning Activity 4.

The Role of Power in Learning

Both the humanistic and constructivist theories of learning place a very different emphasis on

the distribution of power within the learning environment. The more ‘traditional’ approaches

to

learning situate the majority of the control over what is learnt and when, firmly within the

control of teacher or instructor (Butts & Rich 2014). It is for them to decide what should be

learnt, the pace at which it should be undertaken, and largely, the methods used. Indeed,

most educational systems (particularly compulsory education) are predicated on these

principles of teacher control. Humanism and constructivism however, emphasise that it

should be the learner who has greater control over these aspects. This is not to say that the

learner should necessarily have total control, but it does mean that the system of delivery

should be such that learners are able to exert as much freedom and control over their own

learning as possible.

Student centred learning is a popular goal for many mentors and the arguments in favour can

come from various standpoints. From an achievement perspective there is evidence to

suggest that engaging learners in the process of learning is a powerful motivator and results

in a deeper level of learning (Baeten et al. 2010). This is undoubtedly a favourable attribute

given the need to develop a deep level of understanding and commitment within future

practitioners. It can also be postulated that engaged learners also learn how to learn. As can

be seen from the discussion of some of the learning theories above, there is scope for learners

to gain a very good understanding of the processes they undergo when learning. There is

however a deeper issue at the heart of the location of power within learning that highlights

how learning can used to either emancipate or control. Engaging learners provides them with

greater control of learning, but that in turn requires the mentor or practice teacher to trust

their judgment.

Paulo Freire (1970) discusses the potential for education to be used in order to control and

oppress at great length in his book pedagogy of the oppressed. Freire advocates a very deep

level of student centeredness in order to promote learning that is meaningful and significant

for the individual. This is achieved through what he terms ‘critical pedagogy’ in which the

teacher takes on the facilitation role and presents topics and ideas for the learner to discuss

(Freire 1970). This is in opposition to what he refers to the ‘bucket’ concept of traditional

education in which the ‘expert’ teacher deposits their knowledge in the empty vessel that is

the student. Learning is achieved within Freire’s model by the teacher facilitating a critical

discussion among the learners: This would entail the posing of open questions for discussion

and building upon the answers by asking further questions or presenting examples of what

has been discussed for further analysis. As can be seen this approach fits well with the

Learning activity 5 Reflection Point – How realistic do you think are the ideals of student

centred learning within clinical practice? If the student is also to be socialized to standards

of best practice must compromises be found? If so, what sort of compromises have you

negotiated with a student?

What effect do you think allowing students to have a greater degree of control or influence

on what and how things are being learnt, has on development of the progression. At its

extremes it could be argued that too much influence dilutes core standards whilst too little

does not allow the profession to evolve.

constructivist theory of learning as well as the humanistic concepts of personal fulfilment and

betterment.

One of the key things Freire’s theories regarding education highlight, it that learning does not happen

in a sociological vacuum and it is subject to the broad context in which it occurs (Fosnot 2005). The

distribution of power is one of the many socially derived factors that impact of what is learnt, by

whom and how. As with many aspects of their professional practice, Mentors and practice teachers

must be sensitive to the social factors that impact on learning and in particular the issue of socialising

the learning into the practice setting. Etienne Wenger (2000) highlights the complexity and

interconnectedness of the process of entering a professional group, which he would view as a

‘community of practice’. Although not a theory of learning as such, his concept of communities of

practice highlights the need take a less reductionist view of learning. It emphasises how groups form

identities based around what it means to be part of that group, setting out the behaviours, values,

knowledge and skills, or rather ‘practices’ important to the group (Wenger 2000). Learning is

essentially the progression and acquisition of those practices in order to achieve acceptance within the

group. A key consideration when utilising this theory is that a group does not have to be a discreetly

defined entity such as a professional group, it could be a much less formal structure. Clubs and

interest groups also fit into this categorisation, and individuals can belong to multiple communities of

practice. Now complete Learning Activity 5.

Portfolio development

As noted above, this article relates to the 3rd of the Nursing and Midwifery Council standards

for the support of learning and assessment in practice (See Box 1). To meet this standard,

mentors and practice teachers need to demonstrate that they are able to facilitate learning

within the practice setting. This requires a very firm grasp of how people learn and what can

be undertaken to support that process and minimise the impact of potential barriers to

learning. Completion of the reflective activities above will be helpful in evidencing this

standard but there is still scope to expand on this evidence. The material presented above

introduces a variety of viewpoints regarding how people learn. In practice it is likely that

educators will need to use a fusion of these approaches in order to promote effective learning

within their area. Think about the discussions presented above and try to write your own

philosophy of learning. Keep this personal and reflective by relating it to your own

experiences of learning and how this has influenced your current approach. Furthermore,

note if and how the material above might have influenced your ideas and approach to the

facilitation of teaching and learning in practice.

Summary

As discussed above, there are many diverse and differing theories around how individuals

learn, each with its own merits and pitfalls. The developing practice of students can be

analysed and described from very differing viewpoints based upon the particular theory that

is chosen. Mentors and practice teachers are faced with the challenge of deciding which

theories or theory they will select within their mentorship practice. What is important

however, is that due consideration is given the principles and assumptions that underpin the

theories chosen to guide their mentorship practice. At the same time, mentors and practice

teachers should also be mindful that not all learners will respond to the same method in the

same way. This is likely to be steeped in their own history of learning and the assumptions

they have made about how they learn and also, why they learn. Differences in generation,

gender, social background, academic ability and culture will all impact on how the learner

perceives learning and the expectations they have of their mentor and practice teacher. A key

part of the mentor and practice teacher’s role is to develop and understanding of this so that

they can correctly select the best approach or rather approaches to utilise in order to

maximise learning.

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Box 1 – Nursing and Midwifery Council, Standards for the Support of Learning and Assessment in Practice, Standard 3

Facilitation of Learning

Stage 2 - mentor

Use knowledge of the student’s stage of learning to select appropriate learning opportunities to meet individual needs.

Facilitate the selection of appropriate learning strategies to integrate learning from practice and academic experiences.

Support students in critically reflecting upon their learning experiences in order to enhance future learning.

Stage 3 – practice teacher

Use knowledge of the student’s stage of learning to select appropriate learning opportunities to meet individual needs.

Facilitate the selection of appropriate learning strategies to integrate learning from practice and academic experiences.

Support students in critically reflecting upon their learning experiences in order to enhance future learning.

NMC (2008)