Building Skills

A nursing teacher guides students step by step in developing the skill to insert a tube in the patient’s nose that goes to the stomach. Nasogastric tube insertion is a basic skill taught in a Fundamentals of Nursing course. How does the teacher use principles of behavioral learning to teach this skill effectively and efficiently?

Do you engage students in learning that involves a procedural or physical skill? Do students develop the ability to perform something concrete or observable? Do you engage students in a routine (though not necessarily easy) set of mental or physical operations that can be broken into steps and observed? Is there one best way to perform this skill? Is this a task a student attempts and through feedback can get better at it? These are learning outcomes that are well served by building skills. For this way of learning, we rely on the literature about behavioral psychology.

Intended Learning Outcomes What students learn	Way of Learning Origins and theory	Common Methods What the teacher provides
Building skills Physical and procedural skills where accuracy, precision, and efficiency are important	Behavioral learning Behavioral psychology, operant conditioning	Tasks and procedures Practice exercises

Teachers who want to build skills effectively do the following:

• Clearly define observable, measurable learning objectives.
• Perform task analysis to break complex learning activities into steps and substeps, arranged in hierarchical or sequential order if necessary.
• Measure students’ present performance level.
• Identify and remediate prerequisite skills as needed.
• Model the task or tasks to be performed.
• Allow sufficient time and opportunities for students to practice.
• Use various forms of well-timed and specific feedback to shape students’ behavior.
• Find appropriate motivation for students in the form of positive and negative reinforcers.
• Use positive reinforcers to establish behavior; avoid the use of punishment unless necessary to stop harmful behavior.
• Assess actual learning throughout instruction according to the stated objectives.
• Carefully select and use technologies that allow students to practice skills and subtasks while receiving timely and specific feedback.