Stages of Learning

The "learning ladder" depicts man`s progression from knowledge absorption to value adoption. The lenght of time a patient remainst at a particular stage varies.

Unawareness, the first step in the learning process, occurs when the patient has incomplete or inaccurate dental health information, e.g., fluoride causes cancer or soft teeth are inherited.

Awarereness arises when correct information is obtained but it lacks personal meaning for the patient. A patient enters the self-interest stage when he realizes the information is personally meaningful.

The dental health educator can enhance this realization  by the effective use of value clarification. Value clarification exercises allow the patient to reflect on the level of importance oral health has to him personally and how it fits into his lifestyle.

If a patient recognizes that his dental health values are not consistent with his behavior, he experiences cognitive dissonance. Old ideas are discarded for new ones, tension is felt, and the inclination to act results.

This is referred to as the involvement stage. Quickly the patient hastens to act. The action stage is the level at which the patient tests new concepts and practices suggested by the educator.

For example, after 5 days of keeping a diet diary, the patient begins to notice the extencive amount of sweets he consumes. Each day he tries new snack substitutions that do not contain sucrose. He begins experiencing self-satisfaction and gratification in his accomplishments and is now motivated to eliminate the imbalance of values and practice in his life by making permanent cognitive and behavioral adjustments that produce a long-term habit. Once a habit has been formed a new value has been established.

References :

Harris, N.O., Christen, A.G.,1987, Primary Preventive Dentistry.2nd Ed. Norwalk, CT, Appleton & Lange

Read, D.A., Simon, S., Goodman, J., 1977, Health Education : The Search for Values. Eaglewood Cliffs, NJ, Prentice-Hall

Horowitz, L.G., Dillenberg, J., Rattray, J., 1987, Self-care Motivation : A Model for Primary Preventive Oral Health Behavior Change. J. Sich. Health, 57

Badura, A., 1977, Self-Efficacy : Toward a Unifying Theory of Behavioral Change, Psychol. Rev., 84