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ED 287 415 HE 020 833

AUTHOR Underwood, Sandra MillonTITLE Application of Learning Style Theory to Nursing

Education and Nursing Practice.PUB DATE 87NOTE 22p.PUB TYPE Information Analyses (070) -- Viewpoints (120)

EDRS PRICEDESCRIPTORS

MF01/PC01 Plus Postage.*Cognitive Style; Higher Education; *LearningProcesses; *Learning Theories; *Nursing; *NursingEducation; *Student Attitudes

ABSTRACTA structure is proposed by which nurse educators may

unravel the contradictions in learning style research and see moreclearly the importance of learning style theory and its applicationsto nursing education and nursing practice. The application oflearning style theory nest evident in the nursing literature appearsto encompass four major dimensions: (1) learner preference, (2)learner response style, (3) information processing, and (4) cognitivestyle. Utilizing these theoretical notions in educational settingshas been shown to lead to greater achievement of educational goals.It has also been demonstrated to have a significant impact on theattainment of professional outcomes in practice settings includingthe field of nursing. However, many nurse educators note majorcontradictions in the learning style research disseminated inprofessional journals and question its validity for nursing practice.This confusion appears to have resulted from the failure of nurseeducators and nurse researchers to recognize the multidimensionalnature of learning style research and the conceptual framework fromwhich each dimension evolves. It is proposed that research is neededto examine the degree of redundan,:y between conceptual dimensionsdefined within various learning style models. (SW)

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TO THE EDUCATIONAL. RESOURCESINFORMATION CENTER (ERIC)."

US DEPARTMENT OF EDUCATIONOffice of Educat nal Research and Improvement

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41-en;:cument has been reproduced asreceived from the person or organization Voriginating it. '''t

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Points of view of opinions staled in this document do not necessarily represent officialOERI position or policy.

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© Copyright by Sandra Millon Underwood,

1987. All rights reserved.

Abstract

Leaiming style theory has been heralded as usefulin planning instructional experiences for diversepopulations of students. Currently nurse educators areusing learning style theory Cl) as a framework Foridentifying needs of students prior to entry intoprofessional educational programs, and CE) as a means ofidentifying alternative methods of instruction formeeting the educational needs of diverse populations ofprofessional nursing students.

However, many nurse educators note majorcontradictions in the learning style. researchdisseminated in professional journals, and thereforequestion its validity for nursing practice. Thisconfusion appears to have resulted from the failure ofnurse educators and nurse researchers alike to recognizethe multidimensional nature of learning style researchand the conceptual framework from which each dimensionevolves.

This theoretical paper proposes a structure bywhich nurse educators may unravel the tangled web oflearning style research as applied to nursing educationand nursing practice. Considering. the proposed structureand following a review of learning :style literature, onemay better recognize the significant impact of learningstyle theory and its application to nursing practice.

TABLE OF CONTENTS

PageAbstractTable of Contents iiTable of FiguresLearning Style: A Theoretical

Notion 1

Leaining Style Theory: TheoreticalModels 2

Learning Style Theory: Applicationto Nursing Practice

Instructional Preference 5Learner Response Style-Information Processing 11Cognitive Processing 12

Summary and Recommendations forFuture Research 13

References 1q

Figure

2

3

TABLE OF FIGURES

Page

Learning Style Research asConceptualized by Partridge,Claxton and Ralston (1978) 3

Models of Learning Styles(Curry, 1983)

Learning Style Theories:Applications to NursingPractice

6

6

iii

?Iv

. r

Application of Learning Style Theory toNursing Education and Nursing Practice:Examination of Three Theoretical Models

Learning Style Theory:A Theoretical Notion

As a result of previous research efforts in nursingwhich apply learning style theoretical notions tonursing practice and nursing education, learning styletheory is attaining heightened attention. It has.beensuggested that strengthening educational experiencesutilizing inferences from learning style theoryultimately lead to greater achievement of educationalgoals of students in practice oriented disciplines suchas nursing. ;

Learning style, in its most generic sense, has beendescribed as 'an attribute, characteristic or gutlitywithin an individual that interacts with instructionalcircumstances in such a way as to produce differentiallearning achievement. Learning style theorists havesuggested that evaluations of learning style are usefulfor (1) describing individual variations in modes ofperceiving, remembering, and thinking,(2) distinguishing the multiple ways individuals mayapprehend, store, transform and utilize information,(3) categorizing learners in terms of educationalconditions under which they are most likely to learn,and (LI) defining and predicting the amount of structurestudents will ultimately require for learning to occur(Hunt, 1979; Payton, Heuter and McDonald, 1979).

Disscussions of learning styles encompass a diversearray of theoretical and conceptual frameworks relatingsensory partiality, cognitive processes, perceptualpreferences and differential learning environments, andinformation processing strategies to academicachievement. It has been suggested that most of thesesingular notions have profound implications foreducational planning. However, as one considerslearning style as a "whole" it is noted that under thenrubric of learning styles, there is much confusionregarding its definition, its dimensions, and conceptualcharacteristics. As a result, it has been stated by manythat until the conceptual confusion is corrected, thetheoretical applications and academic significance toprofessional disciplines, including nursing, may neverhave significant practical application.

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Learning Style Theory: Theoretical Models

In an attempt to alleviate some of the confusionand describe the, dimensions of learning style, Partridge(1983), Curry C1983), Claxton and Ralston C1978)reviewed many of the research studies on this amorphoustopic. As a result of these research efforts twoalternative. means for conceptually organizing thedimensions of learning style theory were proposed. Oneinvolved the conceptualization of learning style theoryas a three-dimesional non-overlapping structure oflearning theories, and the other a three-dithensionalinterfacing structure of the theoretical notions.

As axesult of a critical review of learning styleresearch, Partridge C1983), Claxton and Ralston C1978)reiterated the conceptual.complexity inherent in theiterature. Itwas suggested that the organizingframework for discussions of learning styles andlearning style research should incorporate three basiccategories: (1) research which focuses on observing howindividuals perceive and respond to stimuli in theirenvironments, referred to as cognitive style research;,C2) research which describes how individuals behave,interact and respond in instructional settings, termedstudent response style; and (3) integrated models oflearning style research which were derived from atheoretically eclectic approach incorporating learningtheory, individual development research and personalitytype studies (Refer to Figure 1).

After carefully considering the conceptualframework, proposed by Partridge, Claxton and Ralston itmight be assumed that the structure provides clear linesof demarcation between the dimensions of learning stylestheory. However, these authors continually reiteratethat while there appears great diversity among thesecategories, there are some interesting yet unresolvedsimilarities between and/or within the learning stylesdimensions.

Following an analysis of a similar body ofresearch, Curry C1983) reported that it appearedreasonable to recommend the categorization of learningtheories into three interfacing strata: the innermoststrata including research related to an individuals'approach to adapting and assimilating information,referred to as cognitive personality style; the secondincorporating research related to the individuals'intellectual approach to assimilating informationfollowing an information processing model; and theoutermost layer including research related to preferenceor choice of learning environment which is referred toas instructional preference (Refer to Figure 2).

Curry, like Partridge and Claxton and Ralston,noted that there was a great deal of similarity and

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FIGURE 1

/.'

/*------------

i \COGNITIVE STUDENT

RESEARCHI RESPONSE

STYLESTYLE -

,--"'-z---------

INTEGRATED\MODELS

OFLEARNING

, STYLERESEARCH/

RESEARCH

II%

LEARNING STYLE RESEARCHCONCEPTUAL MODEL

(PARTRIDGE 1983; CLAYTON and RALSTON - 1978)

LEARNING STYLE THEORIES

4

INSTRUCTIONAL FORMATPREFERENCE INDICATOR

INFORMATION PROCESSINGSTYLE

COGNITIVE PERSONALITYSTYLE

Pia

confusion in the terminology, conceptual dimensions andthe behavioral foci representing learning styles in theliterature. However, within the proposed organizationalmodel it was noted that there appeared a fortuitousstructure which more appropriately described therelationship between the dimensions of learning style(Curry,1983). This model emphasized the notion that alllearning behaviors are fundamentally controlled bycentral cognitive domains and translated into purposefulbehaviors via informational procesing channels wherethey formally and finally interact with instructionalenvironmental factors.

Learning Style Theory:Application to Nursing Practice'

Research on learning styles in nursing and healthrelated disciplines has been sparse, and limited in itsgeneralizability. Nevertheless learning style isperceived as a critical factor affecting learning and isconsidered to have profound implications for planningprofessional education, measuring educational outcomesand anticipating an individuals' ability to fulfillprofessional role functions.

A review of the literature on the application oflearning style theory in nursing education and nursingpractice suggests that the theoretical dimensions oflearning style most salient in nursing could beorganized in a fashion similar to the Claxton, Ralston,Partridge and Curry models. Nursing research relatinglearning style to the various aspects of professionalnursing practice, may be organized into four primarydimensions: (1) research which relates to the "likes"and "dislikes" that professional nurses or studentnurses have for particular sensory modes and conditionsof learning including preferences for certainteaching/learning strategies, referred to as learning(or instructional preference); (2) research whichfocuses specifically on how professional nursingstudents behave, interact and respond in classroomsituations, referred to as student response style;(3) research which defines or describes the perceptualand intellectual activities involved as one responds toand uses stimuli in the context of learning, referred toas coeitive processing research; and C4) the researchthat attempts to describe an individuals' intellectualapproach to acquiring, internalizing and transforming .

stimuli from the environment into some meaningful andpurposeful action--or information processing research(Refer to Figure 3).

Instructional Preference

Most of the learning style research within nursing

1

STUDENTRESPONSESTYLE

\ RESEARCH

FIGURE 3

INS TRUCTIONAL\PREFERENCE\ RESEARCH

i

1

1

I

// COGNITIVE

PROCESSINGRESEARCH

/ INFORMATION1 PROCESSING

RESEARCH/

.,'/

LEARNING STYLE THEORY :APPLICATION TO NURSING PRACTICE

12

Ph

6

deals with learning Cor instructional) preference.These studies discuss the effects that learnerpreference or choice of learning environment have onacademic achievement, learner attitudes and teacherexpectations. In 1974, Canfield and Lafferty attemptedto identify and compare learning style preferences ofstudents in pre-vocational and pre-professional programsinc.Luding criminal justice, education, physical therapy,organizational administration and nursing (Payton, et.al., 1974). They observed significant differences inlearning preferences between these groups. Of all thegroups examined, the physical therapy and nursingstudent groups expressed a significantly stronger needand/or preference for teacher structured organizationand direct instructional experiences.

Ostmae, Uan Hoozer, Scheffel and Crowell attemptedto gather additional data relating learning stylepreferenceand selection of learning strategies innursing populations COstmoe, Van-Hoozer, Scheffel &Crowell, 1984). Following the development of a learningstyle preference questionnaire designed to'elicitinformation on students attitudes towards 28 differentlearning strategies, attempts were made to differentiatethe instructional ,preferences of selected groups ofnursing students. The findings indicated that preferencefor learning methods did exist among the selected sampleof nursing students. In addition the findings revealedthat the baccalaureate nursing students tested preferredlearning strategies that were traditional and structuredin nature. Participant responses emphasized theirpreference for (1) teacher-direction, C2) studentpassivity, and C3) highly organized and structuredlearning environments.

Rather than limit their research to theidentification of group learning style preferences,Ostmoe, Uan Hoozer, Schefffel and Crowell, also soughtto determine if there were differences between thevarious levels of students within the baccalaureatecurriculum. When comparing responses between lowerdivision and upper division nursing students toquestions focused on preference for teaching learningstrategies, the results suggested that students in upperdivision nursing courses preferred the inclusion of non-traditional or innovative learning strategies- such as "'clinical practicum experiences and diverse independentlearning activities. In contrast, beginning studentsappeared to prefer a greater variety of teacher-directedand didactically structured learning experiences.

3t was apparent from these studies thatpreferences for particular learning strategies andlearning experiences were observable in populations ofnursing students. However, the predicted relationshipbetween these learning style preferences and academicachievement in nursing remained unclear. Some nursing

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researchers then suggested that in an attempt to enhancelearner achievement there might be some value instructuring learning environments according to studentlearning style preferences. Others queried if exposingstudents toa variety of learning strategies in order topromote the development of greater flexibility inlearning and problem solving and decision making wasmore appropriate.

Given these issues, authors have sought todetermine if various modes of mat.c1-,ing the learningstyle preference of students contributed to academicsuccess. Lange's 1972 dissertation examined the effectsof matching the learning Styles of students andinstructors in nursing education and reported that whenteachers and students were matched according to learningstyle, the-failu7e withdrawal rate in specific nursingcourses was less among the matched than the non-matchedstudents CLange, 1972). The data presented by Smith andFraizer lead them to suggest that learning styleachievement could be enhanced when instructional methodswere directly compatible with student learning stylepreference CSmith, 1974; Fraizer, 1982). Pascal,likewise, found that students who were taught accordingto their preferred learning style had more favorableattitudes towards the subject matter in particular, andschooling in general; and as a result, weresignificantly more successful in the fulfillment ofstated course objectives CCronbach and Snow, 1977).

Following the examination of 1,009 health sciencestudents, Payton, Hueter and McDonald found that anxietylevels were significantly higher when students receivedinstruction through least preferred learning modes, ormodes that were contrary to their expressed learningstyle CPayton, et. al., 1979). This increased anxietywas expected to lead to decreased achievement ofeducational goals.

McCarthy's report on the identification of learningstyle preferences of students and matching them withteaching formats, revealed that the "matched" studentsprogressed in cognitive variables significantly betterthan the "non-matched" or neutral students. In additionit was observed that affective variables were notaffected by either matching strategy CMcCarthy,1979).Followtng a six year analysis of learning styles andacademic performance of a select group of students,McCarthy concluded by stating that if students' learningstyle preferences can be identified and matchedtospecial teaching formats an important tool forindividualization of curricula would seem appropriate.

In response to recommendations by earlier authorsand researchers, Partridge C1983) suggested that thewisdom of matching nursing student's styles with acongruent instructional mode seemed obvious. It wasreported that students will likely be more comfortable

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with educational interactions most consistent with their

own and will probably learn more efficiently. However,Partridge asserts the indiscriminate use of suchstrategies to enhance achievement in nursing (orelsewhere) may not be quite this simple. It wassuggested that the fallacy is that if a studenthabitually utilizes only one learning style, he or she

may be at a serious disadvantage when confronted withthe necessity to utilize a different mode.

The'report by Claxton and Ralston (1978) suggestthat before attempting to answer the question whether. it

' is best to match students learning style preference. withinstructional. modes, the purpose of the educationalendeavor must first be identified. It was suggestedthat educators first consider whether the purpose of theeducational activity is instrumental (i.e. only to learnthe subject matter or task) or essentially.developmental (i.e. to broaden the student's learningpotential). An earlier report conducted by Altemeyer(1966) adds to this controversy and suggests thataccentuating one kind of learning style can actuallydecrease an individuals' skill in another.

The studies on instructional preference emphasizethe impact that features of the learning environmenthave on the achievement of learning outcomes. However,while the effect of structuring learning environmentsaccording to student preference is described as"obvious" the wisdom of doing so in nursing education isstill at question.

Learner Response Style

There have also been demonstrations of learnerresponse style in nursing settings. Learner responsestyle has been defined as the manner in which anindividual behaves, reacts and/or responds in aninstructional setting. Learner response style is mostcommonly assesses: as the learner "activc1.y" or"passively" engages in instructional activities.

Ferrell (1978), completed an investigation of thelearning style dimensions of adult learners returning toschool to earn an Associate Degree in nursing. It wasreported that fulfilling educational objectives innursing. requires students of nursing to demonstrate a

Ph,

certain degree of flexibility and independence inresponding to the demands of the health care environmentand the objectives of the learning occasion. Usingthe Autonomous Learner Index, a tool designed to obtaininformation as to how independent or dependent anindividual is in attitude and response to learning andthe learning environment, Ferrell (1976) hypothesizedthat evaluations of learner independence versus

. dependence could be implemented to identify learners whomay have difficulty interacting in and responding in

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clinical decision making situations. Such data, Ferrellconcluded, could then be utilized to structureeducational experiences according to the students'learning response style and the clinical instructionaldemands.

Messoff observed that evaluations of learnerresponse style,could also be useful for practicedisciplines such as nursing CMessoff,1979). It wasremarked that the assumption of various leadershipfunctions is critical to any professional role. Withinnursing practice was a vital leadership component whichis necessary for the management of patient populations,student populatiOns or populations of professionalnurses. Following the completion of a literature reviewfocused on reports of learner response style and learnerbehavior, Messoff suggested a practical application oflearner response style to professional role behaviors.Messoff proposed that learners whose response stylesreflected "independence", would favor active participantroles, and theassumption of major leadership functions."Dependent" learners, conversely, would be more apt toassume spectator roles in the learning process andlikewise would be expected to fulfill the less demandinggroup maintenance lunctions when assuming professionalroles.

Following a through examination of the learningstyle research literature, Claxton and Ralston alsoassessed the effect of learner response style onacademic achievement CClaxton and Ralston, 1978).They report evidence suggesting that students with"dependent" learner response styles would demonstrategreater academic success if during the teachingoccasions they are provided reinforcement using verbaland non-verbal feedback. In addition, learners with"dependent" learner response styles were anticipated toachieve greater academic success if taught inenvironments reflecting social approval, warmthexpressed by others and acceptance of the group.Independent learners, on the other hand, were lessinfluenced by feedback such as grades and evaluations,and appeared most motivated and successful when placedin challenging group situations.

Learner response style studies have focusedprimarily on identifying the response styles ofprofessional nursing students. There has been no attemptto classify any dimension as superior to the other. Itwas suggested by Garity C1986), in remarks focused onutilizing learning style as a basis for implementingcreative teaching and learning strategies, that byevaluating this particular learning style dimension inpopulations of nursing students, educators could moreappropriately structure group learning activities mostconsistent with students' response style mode. Such datawere also described as useful for career guidance in

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nursing. Garity's report implies that these measuresmau be useful for students making career choices and inselecting a professional role.

Information Processing

Another learning style approach that has been afocal point for nursing research is that of informationprocessing. Information processing learning style hasbeen -defined as an individuals' intellectual approach toacquiring, internalizing and transforming knowledge fromone's environment into-some meaningful and purposefulaction. Manu of the discussions relating to informationprocessing learning styles have included the theoreticalnotions of experiential learning discussed by KolbC1976). While describing learning as a cyclic process,Kolb suggests that the acquisition of knowledge includesfour stages: (1) engagement in a concrete experience,(2) ofservation and reflection on'the experience,(3) abstraction, conceptualization and generalization ofthe experience, and finally, 0.1)_ testing of the newlyconceived generalizations in new situations. Iftranslated to a clinical nursing situation, thislearning style process would be described as the meansone uses to efficiently gather data from a clinicalsituation and to make a clinical decision or nursingjudgement that will result in the implementation of anappropriate nursing action.

While considering the impact that informationprocessing learning styles have in nursing education,Lesson C19BLI) evaluated information processing learningstyle differences between generic and registered nursestudents in a baccalaureate nursing curriculum. Thereported findings indicated that generic and registerednurse student groups were grossly similar in informationprocessing learning style. However, the data analysisalso revealed that the groups even more closelyresembled each other as they matriculated from lower toupper division coursework.

Other authors noted the impact that knowledge ofone's information processing style had on academicachievement. Skipworth 01976) addressed this issue byexamining the relationship between learning styles andlearning outcomes in the health related discipline of "s.

nursing. Utilizing a longitudinal research design, itwas reported that nursing students with access to datarelated to their inforMation proCessing learning style,when compared to students without such data(1) experienced significantly more success in theircoursework, C2) were more efficient partners in theteaching learning process, and C3) assumed moreresponsibility for the manipulation of learningactivities according to their specific learning needs.Ogden 01978) when examining a comparable group of

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nursing students reported that those who were providedfeedback related to their information processinglearning style were more successful in the completion ofassigned tasks. When given data related to theirinformation processing learning styles, noting areas ofstrength and weakness in acquiring and transforminginformation, Ogden found that the informed group wasreported to manipulate their learning activitiesindependently according to their "supposed" strengthsand subsequently achieve greater academic success.

If the information processing learning style didnot involve environmental variables, it may logically beconsidered a more stable learning style when compared tolearner preference and learner response style. Givenits apparent relationship to processes of problemsolving, information processing is also assumed to havea significant effect on the achievement of learningoutcomes. Nursing practice is founded:on thetheoretical notions related to nursing process, themechanism utilized by nurses to process information forthe purpose of making critical patient .care decisions.However, researchers have not yet attempted to determinethe relationships that may exist between the two.

Cognitive Processing

Another learning style approach, cognitiveprocessing, has gained much interest in nursing.Cognitive style research in nursing has focusedprimarily on the cognitive processing learning styledescribed by Witkin C1977). Cognitive style, asdescribed by Witkin, is a bipolar continuum whichindicates the extent to which a person perceives part ofa field as discrete from the surrounding field as awhole, Ci.e. field independence); or the extent towhich the organization of the prevailing fielddetermines perception of its components Ci.e. fielddependence).

As a result of Witkin's work, nurse educators andresearchers have recommended various teaching andlearning strategies that complement the two diversecognitive processing styles of learners. Miller C1979)analyzed cognitive styles and instructional preferencesin a sample of community college students. Millerreported that field-dependent students preferred PI%

instruction via group discussion and field-independentstudents preferred teacher directed lectures. Cognitiveprocessing styles were also observed by Martens to beaffected by curricula and professional programs(Martens, 1976). Following an analysis of cognitiveprocessing styles of learners in select educationalsequences and professional programs Martens reportedthat field dependence was the overwhelming cognitivemode of students in courses and major that emphasized

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interpersonal skills, groupwork and individualattention, such as nursing.

. Cognitive styles of students were also noted byGariety to influence how students learn CGariety, 1985).Garity remarked that field-dependent individuals learnedbest when (1) material was organized, (2) when learnerswere given salient cues, and (3) when learners wereallowed to rely on the characteristics of the learningtask itself in directing the learning activity. Fieldindependent students were observed to learn mostefficiently and effectively by (1) organizing their ownmaterials, C2) relying on intrinsic motivation Cratherthan external sources) and by C3) setting up their ownrules for testing concepts, opinions and ideas.

Unlike student. preference and student responsestyle, the cognitive processing characteristics of anindividual learner are described as being unaffectedby the learning environment. They are described as .

permanent .structures which are stable attributes of thelearners' personality. As a result, little change can beexpected in the learner himself as environmental factorsare manipulated. However, much greater change ineducational outcomes occurs when this learning stylecharacteristic is taken into account in the selection ofteaching and learning strategies.

Summary and Recommendationsfor Future Research

The application of learning style theory mostevident in the nursing literature appears to encompassfour major dimensions: 1) learner preference, 2) learnerresponse style, 3) information processing, andq) cognitive style. Utilizing these theoretical notionsin educational settings has been shown to lead togreater achievement of educational goals. It has alsobeen demonstrated to have a significant impact onattainment of professional outcomes in practice settingsincluding nursing.

Nevertheless, questions related to the structure ofthe theoretical model itself appear to be yetunresolved. There is no clear cut evidence to supporteither the interfacing or the unidimensional model. Ph.Until research is implemented which focuses on examiningthe degree of redundancy Cor lack of redundancy) betweenthe conceptual dimensions defined within the variouslearning style models is addressed, the questions willremain unanswered.

However, as nurse educators consider each model,and the dimensions they attempt to describe, greaterunderstanding of the conceptual dimensions of learningstyle will undoubtedly occur. As a result greaterapplication of the research findings and reducedconfusion is anticipated.

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References

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Babich, A. and Randol, P. C1976). Learning Styles Inventory:Reliability Report. Murdock Teacher Center: Wichita,Kansas.

Benliett, N. (197q). Learning styles of health professionalscompared to preference for continuing education programformat. Thesis. University of Illinois at Urbana-Champaign.

Claxton, C.S., Ralston, Y. (1978). Learning styles:Theirimpact on teaching and administration. Washington, D.C.:American Association for Higher Education and EricClearinghouse on Higher Education, Research Report No. 167065.

Cranston, C. & McCort. (1985). Learner analysis experiment:cognitive style versus learning style in undergraduatenursing education. Journal of Nursing Education, 211 136-138.

Cronbach, L.J. & Snow, E. C1977). Aptitudes and instructionalmethods. Irvington Publishers, Inc.:New York. Crook, J.

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Ferrell, B. (1978). Attitudes toward learning styles and selfdirection of ADN students. Journal of Nursing Education,17, 19-22.72-85.

Frazier, Z. C1982). The effects of the attitude of learningpreference on two variations of guided design instructionwith nursing students. ED.D. dissertation. University ofSan Francisco.

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Kolb, D.(1983). Professional education andcareer development: Competence in experientialdevelopment. Eric Document, No. 209 '193.

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Martens, K. (1976). A descriptive study of ;cognitive style offield dependence-independence in the new studentpopulation in the coimmunity college and it's relationshipto learning environment and program preferences.Doctoral study, State University of New York,Albany.

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Skipworth, D. (1976). The impact of cognitive style onteaching and learning. Washington, D.C.:American Association for Higher Education and EricClearinghouse on Higher Education, Research Report No.190 7q3.

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Smith, J.R. (1974). Assessing the cognitive style ofstudents in the nursing care of patients having retinaldetatchments. Doctoral Study, Wayne State University,Cleveland Ohio.

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