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How students learn

How students learn

Site: learnonline
Course: Teaching and learning in Health Sciences
Book: How students learn
Printed by: Guest user
Date: Monday, 25 May 2020, 12:17 PM
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In order to get the best results from your teaching endeavours, it is helpful to have a idea of the theory and practice behind student learning.

In this Moodle 'book', you will see various 'chapters' outlining some of the principles behind student learning, which you can use to underpin your course learning and assessment strategies, and some practical approaches to developing effective learning activities.

Just click on the table of contents to the left to go to the different 'chapters', or use the arrows at the top and bottom of  each page to move back and forwards in this book. You can also print the book or any of the chapters out, using the links in the Administration block to the left.

Two very important learning theories to check out are constructivism and student-centered learning - you can find more information from the chapters to the left.

We have also included information on other popular theories about how students learn best, such as:

  • Active learning - in which students solve problems, pose and answer questions, discuss and debate
  • Cooperative learning - in which students work with their peers in on projects which foster positive interdependence and individual accountability

The learning pyramid [Source:]

Interesting links

The Nature of Learning: Using Research to Inspire Practice. 

Practitioner Guide from the Innovative Learning Environments Project. Centre for Educational Research and Innovation. 


Constructivist learning theory emphasizes the learner's critical role in their own learning. 

Constructivism is founded on the premise that we 'construct' our own understanding by reflecting on our prior experiences. We generate our own 'rules' and 'mental models', which we use to make sense of our experiences.

Therefore, when we learn, what we are actually doing is adjusting our mental models to accommodate new experiences.

There are several guiding principles of constructivism:

1. Learning is a search for meaning. The purpose of learning is for an individual to construct his or her own meaning, not just memorize the 'right' answers and regurgitate someone else’s meaning. Therefore, learning must start with the issues around which students are actively trying to construct meaning.
2. Meaning requires understanding the whole as well as understanding parts, and parts must be understood in the context of the whole. Therefore, the learning process must focus on primary concepts, not isolated facts.
3. In order to teach well, we must understand the mental models that students use to perceive the world, and the assumptions they make to support those models.
4. Since education is inherently interdisciplinary, the only valuable way to measure learning is to make the assessment part of the learning process, ensuring it provides students with information on the quality of their learning.

Adapted from

Constructivism concept map [Source:]

Interesting resources

Brandon, A & All, A 2010, 'Constructivism theory analysis and application to nursing programs', Nurse Education Perspectives, vol. 31(2), pp. 89-92.

Candela, L, Dalley, K & Benzel-Lindley, J 2006, 'A case for learning-centered curricula', Journal of Nursing Education, vol. 45(2), pp. 59-66.

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Behaviourism diagramThe basis of the theory of behaviourism is that humans can be trained to produce certain behaviour in response to certain stimuli, and the more often the response is stimulated, the stronger is the training.

More advanced theories of behaviourism look at reinforcement as the focus rather than simple observable reflexes, and state that specific learning can be achieved with the right applications of negative and positive reinforcement (Skinner’s operant conditioning).

Behaviourism has had a bad reputation for a long time, because it's perceived as a low level approach to training and education, which simply relies on producing a behaviour without any consideration of the internal processes that produce the behaviour, just the external response. Many people see this as no more than the level of ‘education’ which we use with dogs, without any idea of free will and choice.

However, there's no denying that throughout our lives, we learn much of what we know from the stimulus-response model, especially as young children. Skinner noted that behaviorism is often is used by school teachers, who reward or punish student behaviours. (Funderstanding, 2002).

While not at such as low level as behaviourism, the premise underlying much authored elearning is based on the concept of rewarding correct answers.

Information processing

information processing model [Source:]

The information processing theory focuses on the idea that humans process the information they receive from the environment, in the manner of a computer, rather than merely responding to stimuli.  

The student's brain brings information in, manipulates it, and stores it ready for future use – this is the learning aspect. 

In information processing theory, as the student takes in information, that information is first briefly stored as sensory storage; then moved to the short term or working memory;  and then either forgotten or transferred to the long term memory, as:

  • semantic memories (concepts and general information)
  • procedural memories (processes)
  • images

This theory addresses how as children grow, their brains likewise mature, leading to advances in their ability to process and respond to the information they received through their senses. The theory emphasizes a continuous pattern of development.

The transference of information to the long term memory is important, as information cannot rest in the short term memory (the short term memory can only hold seven pieces of information at a time). An overload in the short term memory can result in cognitive overload.

Teachers can help students who are suffering from information overload by letting students know what are the critical elements of the information; in other words, prioritizing the information.  

Make sure you have the students’ attention, and help students to make connections between new material and what they already know.

Provide for repetition and review of information, present material in a very clear manner, and focus on the meaning of information.

Download document Helping students memorise: Tips from cognitive science 

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Student-centered learning

"... what the student does is actually more important in determining what is learned than what the teacher does."  Thomas Shuell

The are a number of approaches which aim to optimise how and how much students actually learn from a teaching activity, but one of the most important is to develop student-centered learning strategies, which are based on the foundation of constructivism. 

Most modern tertiary institutions actively practice (or claim to practice) program delivery methods which encourage students to take an active role in creating the learning and assessment processes.

Student-centered learning strategies shift the focus of activity from the teacher to the learners, and are particularly relevant to tertiary and professional education, because they foster motivation and incentive to learn. In acting as a facilitator guiding the students, rather than just instructing them, the teacher is allowing the learners take an active part in deciding what they learn, how they learn and how they can evaluate what they have learnt. 

Ideally, this means that the learners have more responsibility and ownership of their learning, and are not simply passive ‘vessels’ receiving knowledge from the teacher. 

Student-centered strategies emphasise each student’s interests, abilities and learning style. Where these types of strategies have been actively adopted in tertiary programs, the evidence suggests that the students have developed greater skills for independent problem solving, critical thinking and reflective thinking. The approach has also increased their confidence in their knowledge and skills. 

The input which the students have in their learning also have implications for assessment – in a student-centred classroom, they will be more involved in deciding how to evaluate and demonstrate their learning. 


Putting it into practice

Learning contracts are mutual agreements between teachers and students which state explicitly what a learner will do to achieve specific learning outcomes, and how their learning will be measured and evaluated. 

They foster an increased responsibility for their own learning. Contracts can include learning expectations, learning resources, learning experiences, documentation and other information such as designated evaluators, evaluation criteria and timelines. 

Source: Teaching Strategies Promoting Active Learning in Healthcare Education 

Interesting resources

Azer, S 2013, Making sense of clinical teaching: A hands-on guide to success, Boca Raton, CRC Press/Taylor & Francis.

Bradshaw, M & Lowenstein, A 2014, Innovative teaching strategies in nursing and related health professions, Jones and Bartlett Learning.

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Active learning

Active learning is the process in which students engage in activities such as reading, writing, discussion, or problem solving that promote analysis, synthesis, and evaluation of class content. Cooperative learning, problem-based learning, and the use of case methods and simulations are some approaches that promote active learning. 

Active learning pyramid [Source:]

When students are actively engaged, they think deeper about the course content, and enjoy their learning. This can be through a range of activities: group work, project work, interactive online activities, peer teaching, and so on. Students must be actively participating in and reflecting on the activities to enhance their higher order thinking capabilities. 

The key principles of active learning are:

1. The task has purpose and relevance to the students.
2. The students are able to reflect on the meaning of what they have learnt.
3. The students can negotiate goals and methods of learning with the teacher.
4. The students can critically evaluate different ways and means of learning the content.
5. The complexity of the learning tasks is comparable to professional contexts and real life.
6. The tasks are situation-driven: that is, the need of the situation is taken into consideration in order to establish the learning tasks.

Adapted from Barnes, D 1989, Active Learning, Leeds University TVEI Support Project. 

Putting it into practice: Applications in Health Sciences

1. Health educators can use questioning strategies to develop critical thinking, decision making, and problem solving in students. Word your questions so that they challenge the students to use a higher level of cognitive development (analysing, evaluating and creating). For example, asking a student to define a type of x-ray would test their ability to remember, but asking a student to assess a request to perform that x-ray on a patient with particular symptoms would test ability to evaluate, and prompts the student to think more deeply about the material. 

2. Self-evaluation is a type of self-directed learning which   allows students to assess their own performance. As a result, they become more independent, and are able to identify knowledge and understanding weaknesses.  The aim of the self-evaluation activity is to assist students to identify strengths and weaknesses in their learning, to set their own performance goals, and to increase their satisfaction with their learning - all key elements of the clinical and professional work environments. However, be aware that students can tend to be overly critical of their own performance 

Adapted from

Interesting resources

Active learning processes used in US Pharmacy Education

Wilson, L & Rockstraw, L 2012, Human simulation for nursing and health professions, Springer Pub Co, New York, NY.

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Collaborative learning

Collaborative learning encompasses a whole host of learning approaches which use the group and team approach to student work. When the group work activities are carefully planned, we are aiming for cooperative learning, in which students work together to accomplish a common academic goal.

Effective collaborative learning will optimise peer learning, in which students learn from and teach each other.

Examples of collaborative learning activities are: group problem solving tasks; team writing assignments, with the aim of a group-authored document; and reciprocal teaching, in which students act as teachers to lead discussion, summarize material, ask questions, and clarify material. These can all be incredibly effective approaches in the classroom, and it should be remembered that teamwork is an important element in equipping students for success in industry ... but it needs to be carefully set up and prepared. 

When planning collaborative learning activities, such as group carefully consider the goals of the activity, to make sure that there is sufficient depth for each group member to have meaningful input.

Try to shape the activity to allow for various group personalities (such as the creative contributers, finishers, etc) each to have the opportunity to shine. Note that you will need to work out how to fairly assign marks to the final product. The self and peer assessment strategy, in which students assess each others' contributions using a list of criteria, may help here, especially if the students have been involved in establishing the criteria used. 

It's also important to remember that students need to be taught how to work together productively in groups - many of them don't find group work easy, and groups that are thrown together do not necessarily succeed. They must develop the skills to maintain a positive interdependence - in which each students depends on the others for success - along with individual accountability. Groups must be set , social skills, group processing, and appropriate grouping.

A number of collaborative teaching spaces have been set up throughout the UniSA campuses, in which the physical layouts and technical sharing functions have been especially created to optimise group work and collaborative learning. At the City East campus, there are two Collaborative Teaching Spaces: in the library, in room C4-08, and room C6-26. You can see an image of room C4-08 below. 

Collaborative Teaching Space

Putting it into practice: Examples of successful collaborative learning in Health Sciences

Collaborative learning in the health sciences can be used in the context of student placement. Groups can be arranged for students to come together to reflect on, and find possible solutions to, any issues that arise on their placement.

The teacher should act as a facilitator if only to encourage all students to find their voice and ensure that the potential solutions that arise are acceptable solutions for the problems faced. Students should collectively problem-solve, drawing on their own experiences, learning and understanding to create better outcomes. 

(Adapted from: Myron, R, French, C, Sullivan, P, Sathyamoorthy, G, Barlow, J & Pomeroy, L 2018, 'Professionals learning together with patients: An exploratory study of a collaborative learning Fellowship programme for healthcare improvement', Journal of Inter-professional Care, vol. 32, no. 3, pp. 257-265.)

Another example of cooperative learning is adopting a team approach to learning a particular concept. The concept could be broken down in to sections whereby each member of the team needs to learn and become the ‘expert’ of a particular section.

The ‘expert’, once mastering the content, needs to identify an effective way to engage and instruct the group, so they too can become ‘experts’. This strategy requires the student to teach others, an active learning strategy that achieves higher information retention rates than more passive learning strategies.

(Adapted from: Cinelli, B, Symons, C, Bechtel, L & Rosecolley, M 1994, 'Applying cooperative learning in health-education practice’, Journal Of School Health, vol. 64, no. 3, pp. 99-102.)

Interesting resources

Sydney University: Self and Peer Assessment

A team-based learning guide for students in health professions education

Team-based learning: A transformative use of small groups in college teaching

Tolsgaard, MG 2016, 'Collaborative learning of clinical skills in health professions education: the why, how, when and for whom' Medical Education vol. 50(1), pp. 69-78.

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Thinking and mind tools 

Thinking tools can provide a scaffold to help students to think with more depth and structure, and can be very valuable in giving students a framework for individual and group problem solving.

There are many examples of thinking and mind tools which can be effectively used in educational contexts: for example, you've probably heard of the  de Bono 6 Hats thinking strategy, and everyone's heard of brain-storming.

It's important to select the right tool for the particularly educational activity, and to scaffold the students' use of the tool carefully. You'll probably find that an approach which works well in one context is not really effective in another - keep careful note of what works with your students at various levels and in a range of problem solving activities. 

We have prepared a resource which outlines the use of a number of thinking tools, including

In this resource, you'll see guidelines on best use of the tool in teaching, ideas on putting the tool into practice in Health education, and links to further resources.

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Cognitive theory of multimedia learning

“People learn more deeply from words and pictures than from words alone”.

The quote above is true ... however, just putting text and pictures together does not necessarily make for effective learning.

When we are using a variety of media in our teaching (test, images, video, interaction), we need to consider the best way for students to learn.

The Cognitive Theory of Multimedia Learning gives guidance for informed multimedia instructional messages.

This theory is based on three assumptions:

  • Humans have separate channels for processing visual and auditory information (dual channels)
  • Humans are limited in the amount of information that can be processed in each channel at one time (limited capacity)
  • Humans engage in active learning by attending to relevant incoming information, organising selected information into coherent mental representations, and integrating mental representations with other knowledge (active processing)

For example, information presented to a student using both auditory (narration) and visual (text) displays requires the student to process this information using both channels. However, the student's ability to process is limited. If a students is receiving information from both channels, his or her mind is forced to be selective with the information it chooses to keep, and which bits of information he or she should make connections between.

Putting it into practice: Instructional goals for multimedia instruction

The table below offers a brief overview of three instructional goals in multimedia learning, bearing in mind the assumptions we discussed above. You might find it useful to consider the various techniques listed in the third column when creating a multimedia learning activity.

Interesting resource

Mayer, R 2014, 'Cognitive theory of multimedia learning', Richard Mayer, The Cambridge Handbook of Multimedia LearningCambridge University Press, Cambridge, UK, pp. 43-71


Representative technique

Description of technique

Minimize extraneous processing

Coherence principle

Eliminate extraneous (non-relevant) material


Signaling principle

Highlight essential material


Redundancy principle

Do not add printed text to spoken text


Spatial contiguity

Place printed text near corresponding graphic          


Temporal contiguity principle

Present narration and the corresponding graphic simultaneously

Manage essential processing

Segmenting principle

Break a presentation into parts


Pre-training principle

Describe names and characteristics of key elements before the lesson


Modality principle

Use spoken rather than printed text


Multimedia principle

Use words and pictures together rather than words alone

Foster generative processing

Personalization principle

Put words in conversational style


Voice principle

Use human voice for spoken words


Embodiment principle

Give on-screen characters humanlike gestures


Guided discovery principle

Provide hints and feedback as learner solves problems


Self-explanation principle

Ask learners to explain a lesson to themselves


Drawing principle

Ask learners to make drawings for the lesson


Adapted from: Mayer, R 2014, Cognitive theory of multimedia learning, Richard Mayer, The Cambridge handbook of multimedia learning, Cambridge University Press, Cambridge, UK, pp. 43-71