NUR 635 Module 2 Theory Comparison Example

Four Theories, One Lesson: Comparing Behaviorist, Cognitivist, Constructivist and Adult Learning Approaches to Teaching Enoxaparin Self-Injection

[Student Name]

Southern New Hampshire University

NUR 635: Teaching and Learning for Nurse Educator

Module Two Theory Comparison

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Four Theories, One Lesson: Comparing Behaviorist, Cognitivist, Constructivist and Adult Learning Approaches to Teaching Enoxaparin Self-Injection

Learning theories are often taught as a list to memorize, each with its founders and key terms, and then set aside when real planning begins. A more useful way to understand them is to ask what each would recommend for the same lesson. This paper compares four theories by applying them to one teaching task in a second-year pharmacology course: preparing nursing students to teach a patient being discharged on enoxaparin how to inject it and when to seek help. It argues that each theory explains part of what students must learn, that none is sufficient alone and that a deliberate blend fits the task best.

The Teaching Task

The composite course at Harborside University enrolls 72 second-year baccalaureate students. Clinical faculty report that students can recite enoxaparin's mechanism but hesitate when a patient asks practical questions, such as where to inject, what to do about a bruise or when bleeding is serious. The task has three parts: a psychomotor skill, the injection technique; conceptual knowledge, why the drug is given, how it affects clotting and which signs of bleeding matter; and a communication skill, teaching a worried patient who may have limited health literacy.

Behaviorism

For the behaviorist, learning is visible: a response becomes more likely when it is followed by reinforcement. An instructional design comparison of the three major traditions describes behaviorist instruction as specifying observable objectives, breaking tasks into steps, providing practice with immediate feedback and reinforcing correct performance (Ertmer & Newby, 1993). A behaviorist lesson would teach the injection as a checklist of steps: hand hygiene, site selection on the abdomen at least two inches from the navel, pinching the skin, inserting the needle at 90 degrees, not expelling the air bubble, injecting slowly and not rubbing the site. Students would practice on pads until they performed every step correctly, with the instructor giving immediate feedback. This approach suits the psychomotor component well, and a checklist also gives the instructor a consistent standard for signing off competence. It says little, however, about why each step matters or how to adapt teaching to a patient who asks an unexpected question.

Cognitivism

Cognitivism focuses on the mental processes of attention, memory and organization of knowledge. The same comparison describes cognitivist instruction as organizing information so it connects to what learners already know and managing the load on working memory (Ertmer & Newby, 1993). Cognitive load research adds that working memory is limited and that instruction overloading it, for example by requiring novices to solve problems without guidance, interferes with learning (Sweller, 1988). A cognitivist lesson would start with a brief review of coagulation that students learned in pathophysiology, present a clear diagram of how enoxaparin affects clotting factors and use worked examples: a completed teaching plan for a sample patient, annotated to show why each point is included. This approach suits the conceptual component and helps novices avoid overload, but on its own it may leave students knowing why without practicing how.

Constructivism

Constructivism holds that learners build understanding by making meaning from experience, often in social interaction, rather than receiving it. Constructivist instruction emphasizes authentic tasks, collaboration and reflection (Ertmer & Newby, 1993). A constructivist lesson would present a realistic case: Mrs. S., a 68-year-old woman going home after hip replacement, who lives alone, has arthritic hands and is frightened of needles. Small groups would decide what she needs to know, how to adapt the teaching and what questions she might ask, then role-play the teaching and discuss what worked. This approach suits the communication component and builds judgment about adapting to a patient. Its risk, supported by cognitive load research, is that novices faced with a complex case before they have basic knowledge may flounder.

Adult Learning

Knowles's account of adult learning proposes that adults are self-directed, bring experience that is a resource for learning, are ready to learn what they need for real roles, prefer problem-centered learning and are motivated mainly by internal factors (Knowles et al., 2015). Many second-year students are working adults, some with experience as nursing assistants or caring for relatives on anticoagulants. An adult learning approach would invite students to share those experiences, explain early why the lesson matters for their first clinical rotations and let them choose among practice scenarios. The approach supports motivation and relevance. Its principles are better described as assumptions than as tested laws, and not every student is equally ready for self-direction, especially with unfamiliar content. A student who has never given an injection cannot be self-directed about technique in any useful sense; self-direction becomes realistic only once the basics are in place, which is one reason the blended design below delays choice until later in the lesson.

A Blended Design

The comparison suggests sequencing the theories to match the task and the learners' growing expertise. The lesson would begin with adult learning: students share experiences with anticoagulants and hear why the skill matters for their upcoming rotation. It would move to cognitivist instruction: a short review of coagulation, a diagram and an annotated worked teaching plan to manage load. Behaviorist practice would follow: students practice the injection steps on pads with a checklist and immediate feedback until performance is correct. The lesson would end with constructivist application, once students have both the knowledge and the practiced skill: the case of Mrs. S., role-played in groups, followed by reflection on how they adapted their teaching. This order moves from guidance toward independence as knowledge builds, which is consistent with cognitive load research on novices.

Conclusion

Each learning theory explains part of what nursing students must learn to teach enoxaparin self-injection: behaviorism the steps, cognitivism the understanding and the management of load, constructivism the adaptation to a real patient and adult learning the motivation. Applied to the same task, the theories become complementary tools rather than rival doctrines, and a sequence that moves from guided to independent learning uses the strengths of each.

References

Ertmer, P. A., & Newby, T. J. (1993). Behaviorism, cognitivism, constructivism: Comparing critical features from an instructional design perspective. Performance Improvement Quarterly, 6(4), 50-72. https://doi.org/10.1111/j.1937-8327.1993.tb00605.x

Knowles, M. S., Holton, E. F., III, & Swanson, R. A. (2015). The adult learner: The definitive classic in adult education and human resource development (8th ed.). Routledge.

Sweller, J. (1988). Cognitive load during problem solving: Effects on learning. Cognitive Science, 12(2), 257-285. https://doi.org/10.1207/s15516709cog1202_4