Concept of Social cognitive theory and its application in the field of

Journal of Positive School Psychology http://journalppw.com

2022, Vol. 6, No. 4, 5161 – 5168

Concept of Social cognitive theory and its application in the field

of Medical and Nursing education: framework to guide Research

Barkha Devi,

Shrijana Pradhan,

Doma Giri,

Nazung Lepcha

Associate Professor, Sikkim Manipal College of Nursing, Sikkim Manipal University, Sikkim, India,

barkha.d@smims.smu.edu.in

234

Assistant Professor, Sikkim Manipal College of Nursing, Sikkim Manipal University, Sikkim, India

Abstract

To bridge the gap between classroom teaching and clinical practice, educators must be innovative. In

medical and nursing research, the Social Cognitive Theory has been employed extensively. Albert

Bandura, a prominent Stanford psychology professor, devised this learning theory. The idea provides

a framework for analyzing how people shape and are shaped by their surroundings. The theory delves

into the processes of observational learning and modelling, as well as the role of self-efficacy in

behaviour creation. According to the concept, people are considered as active participants who both

influence and are impacted by their surroundings. Type of learning is a crucial element of the theory:

it is the process of learning desirable and unpleasant actions by seeing others and then imitating those

behaviours to maximize rewards. Individuals' self-efficacy views have an impact on whether or not

they will repeat an observed activity. In the design of some research methodologies, a theoretical

framework is not explicitly used. The purpose of this paper is to focus on Bandura's social cognitive

theory's contribution to the field of education, as well as to assist researchers in understanding the

nature of theoretical and conceptual frameworks, and how they can be used to help steer research or

be recognized as a result.

Keywords: Behavior Change, Cognition Self Concept, Bandura's social learning theory, Social

cognitive theory, video modeling, Observational learning, Theoretical framework.

INTRODUCTION

The act of generating ideas, designs, and plans

is known as conceptualization. A framework is

a collection of concepts that have been grouped

together due to its relevance to research

concerns, and it serves as a reference point for

clinical practice, research, and teaching.

Theoretical and conceptual frameworks, in

general, give a grasp of the phenomenon of

interest and represent the models' assumptions

and philosophies.1 The model provides

guidance for research design, data gathering,

and conclusion evaluation. The social learning

theory describes how people learn through

watching others. Students copying the teacher

is an example of social learning theory. This is

disappointing because the major purpose of

public healthcare is to preserve rather than

initiate good habits in terms of peripheral

association of environmental stimuli to

responses, was founded in a context where "

the dominant learning theory relied almost

entirely on learning through the impact of one's

activities as measured by the marginal

relationship of external changes with

responses.2

Albert Bandura developed Social

Cognitive Theory as the Social Learning

Theory in the 1960s. It was renamed the Social

Cognitive Theory in 1986, and it proposes that

learning takes place in a social setting, with a

dynamic and reciprocal interaction between the

person, their environment, and their behaviour.

The emphasis on social influence and external

Barkha Devi 5162

and internal social reinforcement are distinctive

features of Social Cognitive Theory. 3

The distinctive way in which

individuals acquire and sustain behaviour is

considered in Social Cognitive Theory, as well

as the social setting in which individuals do the

behaviour. The idea considers a person's past

experiences, which influence whether or not

they will engage in behavioural action. These

prior experiences have an impact on

reinforcements, expectations, and expectancies,

all of which influence whether or not a person

will engage in a particular action and why they

do so.3,4

Many behaviour theories employed in

health promotion do not examine habit

maintenance, instead focusing on behaviour

initiation. This is unfortunate because the

primary goal of public healthcare is to maintain

rather than begin behaviour. The purpose of

Social Cognitive Theory is to explain how

people manage and reinforce their behaviour in

order to produce goal-directed conduct that can

be sustained over time. The first five constructs

were developed as part of the Social Learning

Theory, and when the theory evolved into

Social Cognitive Theory, the construct of self-

efficacy was included.5

1. Reciprocal Determinism - Reciprocal

determinism is the central principle of Social

Cognitive Theory. This is defined as the

dynamic and reciprocal interaction between a

person (individual with a set of learned

behaviors), their environment (outside social

circumstances), and their behaviour (responses

to stimuli to achieve goals).

2. Behavioral capability - This relates to

an individual's ability to carry out a task

utilizing the appropriate knowledge and

abilities. In order to complete a task

successfully, a person must know what to do

and how to execute it. Learners understand by

the consequences of their activities, which

affect their surroundings.

3. Observational Learning - According to

this hypothesis, humans may witness and

observe the actions of others before imitating

them. "Modeling" behaviours is a common way

to demonstrate this. Individuals can complete

an activity successfully if they witness a

presentation of the behaviour.

4. Reinforcements - These are the internal

or external reactions to a person's behaviour

that influence whether or not the activity is

sustained. Reinforcements can be positive or

negative, and they can come from within or

outside of the person. This is the social

cognitive theory construct that most closely

resembles the reciprocal interplay of behaviour

and environment.

5. Expectations - This refers to what a

person anticipates to occur as a result of their

actions. Expectations for results can be either

health-related or not. People evaluate the

consequences of their actions before

participating in a behaviour, and these thoughts

can affect whether the behaviour is done

successfully. The majority of expectations are

based on previous experiences. Expectancies

are subjective to the person and focus on the

importance placed on the outcome, even though

they are founded on prior experience.

6. Self-efficacy - This refers to a person's

belief in his or her own ability to accomplish a

task successfully. Self-efficacy is unique to

social cognitive theory, while other theories,

such as the Theory of Planned Behavior, have

added it at a later period. Individual capacities

and other personal characteristics, as well as

environmental influences, all influence self-

efficacy (barriers and facilitators).1,2,4,5

The six components listed above all

highlight the social cognitive theory most

significant aspect, which is the mutual link

between people and their surroundings.

External or environmental elements that are

directly related to social support are used to

determine reciprocal determinism in this study.

Behavioral competence and observational

learning are terms used to describe the process

of learning skills and knowledge from others

through observation or participation in the

society, which is also linked to social support.6

Reinforcement must come from the

environment in which he or she lives, as well as

from social support. People's expectations are

linked to their beliefs. Self-efficacy is also

linked to social support when the person's

living environment is taken into account.6

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Concept of Social Cognitive Theory:

Social cognitive theory is a learning

theory based on the premise that people learn

by seeing what others do and don't do, and that

these processes are crucial to understanding

personality. While social cognitists

acknowledge that acquired conduct

demonstrated in one's environment has a

significant impact on growth, they argue that

the particular person (and thus cognition) is just

as essential in determining moral

development.7

People learn by watching others, with

the environment, behaviour, and cognition all

playing a role in shaping their growth. These

three parts are not static or autonomous; rather,

they interact with one another in a triadic

reciprocal determinism process.7

The Bobo Doll Experiments-Origin of the

social cognitive theory

Albert Bandura's first source of

inspiration was his academic training, which he

received at a school with few resources and

ineffective teachers. In addition, following a

strike at that institution, he had to take care of

his own education. This is how Bandura

described the learning process: "Learning on

one's own was a practical tool for personal

progress, not a theoretical abstraction. Instead

of becoming an insurmountable defect, the lack

of educational resources became an

empowering aspect that has greatly aided me

".8

Furthermore, Bandura states that he

was influenced by behaviourists such as

Watson and Thorndike and their work on

learning by observation and its divergence, as

well as Miller and Dollard's work on social

modelling on social learning and imitation,

with which he had discrepancies, prompting

Bandura to conduct research on the subject.

Bandura's theory arose from a study of the

principles of learning in the human social

setting, which led to his original formulation of

the Theory of Social Learning. Later, Bandura

incorporated cognitive psychology aspects to

provide a broader understanding of human

functioning from the standpoint of human

thought and action's social origins.9

The process of knowledge acquisition

or learning is directly linked to the observation

of models in social cognitive theory.

Interpersonal imitation or media sources might

be used as models. Modeling effectively

teaches general norms and solutions for coping

with a variety of scenarios. Albert Bandura and

his colleagues developed a series of tests with a

Bobo doll in 1960 to demonstrate that people

learn by watching others. Children were

exposed to either an aggressive or non-

aggressive model of the same sex or opposite

sex as the kid in the first trial.10

The model was vocally and physically

violent towards an inflated Bobo doll in the

presence of the child in the aggressive

condition. The youngster was transported to

another room after being exposed to the model

to play with a variety of extremely appealing

toys. The child's play was halted after roughly

two minutes to annoy the participants. The

youngster was then transported to a third room,

which was stocked with various toys, including

a Bobo doll, where they were allowed to play

for the next 20 minutes.11

The children in the aggressive

condition were far more likely to demonstrate

verbal and physical aggressiveness, including

aggression against the Bobo doll and other

forms of aggression, according to the

researchers. Furthermore, males were more

likely than girls to be aggressive, particularly if

they had been exposed to an aggressive male

model.12

A similar approach was used in a

subsequent experiment, but this time the

aggressive models were not just viewed in real

life. A second group watched a film with an

aggressive model, while a third group watched

a cartoon figure with an aggressive personality.

The model's gender was varied once again, and

the youngsters were mildly frustrated before

being brought to the experimental room to play.

The children in the three aggressive conditions

acted more aggressively than those in the

control group, and boys in the aggressive

condition acted more aggressively than girls, as

in the prior trial.12

These investigations provided the

foundation for notions about observational

learning and modelling in the real world and in

the media. It sparked a debate about how media

models might negatively impact children,

which is still going on today. Bandura

Barkha Devi 5164

introduced Social Learning Theory in 1977,

which expanded on his concepts of

observational learning and modelling. Then, in

1986, Bandura renamed his theory Social

Cognitive Theory to emphasize the cognitive

aspects of observational learning as well as the

interactions between behaviour, cognition, and

the environment in shaping people.9,10

Teachers serve as role models for

children when it comes to learning. Both the

material aims and the underlying curriculum of

virtuous life are modelled by teachers. Teachers

should also be committed to helping pupils

develop high levels of self-efficacy by

applauding their achievements. 9

Observational learning models:

Observational learning is an important

part of social cognitive theory. In contrast to

behaviourists like B.F. Skinner, Bandura's

beliefs regarding learning were radical. Only

through taking individual action, according to

Skinner, could learning be attained.

Observational learning, on the other hand,

allows people to acquire information

considerably more quickly, according to

Bandura, because it allows them to observe and

mimic models they encounter in their

surroundings.11

Observational learning is accomplished through

a series of four steps:

1. Attentional processes account for the

information in the environment that is chosen

for observation. People may choose to watch

real-life models or models they see in the

media.

2. Retention mechanisms entail

memorizing what has been witnessed so that it

can be recalled and recreated later.

3. Production processes reconstruct

observation memories so that what has been

learned can be applied in appropriate settings.

In many circumstances, this does not mean that

the observer will perfectly reproduce the seen

action, but rather that they will alter the

behaviour to produce a version that is

appropriate for the situation.

4. Motivational processes determine

whether or not an observed behaviour is carried

out, based on whether the conduct is viewed to

produce desired or undesirable results for the

model. If an observer is rewarded for observing

a behaviour, he or she will be more encouraged

to repeat it later. The spectator, on the other

hand, would be less motivated to repeat a

conduct if it was punished in some way. As a

result, social cognition theory warns that people

do not model every behaviour they learn.

Self-Efficacy

Albert Bandura also emphasized that

the most straightforward way to demonstrate

moral development is to evaluate a variety of

circumstances, whether social, cognitive, or

environmental. The link between the three

variables above sheds even more light on the

complicated topic of morality. Models can

boost or reduce the observer's conviction in

their self-efficacy to enact seen actions and

bring about desired results from those

activities, in addition to the knowledge they can

impart during observational learning. People

believe they can succeed if they see others who

are similar to them succeed. As a consequence,

models can be used to motivate and inspire

people.12

Self-efficacy has also been used to

predict behaviour in a variety of health-related

scenarios, including weight reduction, smoking

cessation, and heart attack recovery. In terms of

exercise research, self-efficacy has provided

some of the most consistent results, indicating

that as self-efficacy rises, so does exercise

participation.12,13

Modeling Media

Serial dramas developed for

developing communities on themes such as

literacy, family planning, and women's status

have proved the prosocial potential of media

models. These dramas have been successful in

promoting good social change while also

illustrating the relevance and applicability of

social cognitive theory to the media. In India,

for example, a television show was created to

elevate women's status and advocate smaller

families by including these concepts into the

show. The show promoted gender equality by

featuring characters who exemplified female

equality.13

There were other figures who emulated

subservient women's roles, as well as some

who changed from subservience to equality.

The show was well-liked, and despite its

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melodramatic plot, audiences understood the

themes it was trying to convey. Women should

have equal rights, the freedom to choose how

they live their life, and the ability to control the

size of their families, according to these

viewers. The ideas of social cognition theory

have been used in this and other examples to

make a beneficial impact using fictional media

models.11,12,13

Vicarious Learning

The concept of vicarious learning, or

learning from other people's actions, is

important to social cognitive theory and self-

efficacy. Individuals can witness observed

activities of others and then replicate those

actions, according to this theory. As a result,

people are less likely to make mistakes and are

more likely to conduct activities successfully if

they watch others do so. Social modelling is

one of the four ways to enhance self-efficacy,

and it includes vicarious learning. Social

modelling encompasses not only observing

conduct but also obtaining advice and direction

on how to carry out that action. 11,12,13

Mastery experience, improving bodily

and emotional conditions, and verbal

persuasion are the other three techniques. The

mastery experience is a method in which a

therapist or interventionist helps an individual

achieve accomplishment by setting small,

incremental goals. 11,12,13

Applications of Social Cognitive Theory:

In medical and nursing research, the Social

Cognitive Theory has been employed

extensively. Learning, according to the notion,

occurs when there is a dynamic and reciprocal

relationship between the individual, their

environment, and their behaviour.

Social Cognitive Theory – Examples

Chattanooga CARES' Healthy

Relationships programme is a small-group

intervention for those living with HIV/AIDS.

The programme is founded on the Social

Cognitive Theory, and it employs skill-building

exercises to help participants gain

independence and cultivate healthy habits.14

Dewar et al. created and tested social

cognition measures relating to adolescent

eating habits. They discovered that the findings

support the factorial validity and reliability of

social cognitive measures of healthy eating

practises in adolescents. They suggested that

the social cognitive theory could also be

utilised to change health behaviour in the

context of other health issues.15

Whittemore looked at metabolic

control and self-management in women with

Type 2 diabetes, as well as psychosocial

adjustment. She discovered that social support

and self-confidence in diabetes self-

management in women with Type 2 Diabetes

can assist people with the disease in

determining and setting personalised goals as

well as developing appropriate solutions.

Persons with diabetes can improve their

metabolic control, self-management

achievement, and psychosocial adjustment to

the disease with increased social support and

self-confidence in diabetes self-management.16

From January to March 2005, Bai et al.

conducted a correlational study at three

hospitals in southern Taiwan to look at the

factors that influence self-care behaviour in 165

type 2 diabetic patients over the age of 65. The

Personal Resource Questionnaire 2000 (PRQ

2000), Diabetes Self-Care Scale, and Taiwan

Geriatric Depression Scale were used to

interview the subjects (TGDS). The study

found a significant correlation between social

support and self-care behaviours, implying that

social support has a favorable impact on self-

care behaviour.17

Barrera et al findings demonstrated the

necessity of social support in both theory and

practise. The research added to the growing

body of data indicating social support has a

direct impact on a person's health behaviours.

Through pathways including immune system

reactions, social ties appear to contribute to a

person's health. Social services can help people

maintain a healthy diet and engage in physical

activity. For a long time, it has been suspected

that the link between social support and

mortality could be explained in part by

healthful behaviours. People who have positive

social ties are more likely to look after

themselves. This mechanism might be used in

interventions like the one Barrera and

colleagues evaluated in their study.18

Khuwatsamrit et al. evaluated the

benefits of social support in Thai adults with

cardiovascular disease and discovered that

Barkha Devi 5166

support from family and friends significantly

improved adherence to self-care behaviours.

Social support has a substantial positive impact

on self-care practise confidence.19

Mohammadreza et al. conducted a

quasi-experimental study with 189 high-school

male students to establish the variables

underlying Waterpipe use and to construct an

intervention programme based on social

cognition theory to diminish the desire for

Waterpipe smoking. Data was collected using a

validated questionnaire based on SCT

components. The most significant changes

were found in the knowledge score, which

increased from 10.70 4.38 to 16.52 3.89 (P

0.0001), and the outcome values score, which

increased from 12.40 3.81 to 13.53 4.23 (P =

0.007); however, no significant changes were

identified in the control group's posttest results.

As a result of the findings of this study, more

effective educational interventions based on

this theory were advised, with a higher

emphasis on self-efficacy and contextual

factors.20

Fatemeh et al. undertook a quasi-

experimental study in 2019 to see how an

empowerment programme based on social

cognition theory affected the daily activities of

70 COPD patients referred to Kashani and

Hajar facilities. The samples were separated

into two groups: experimental and control, at

random. The study found that patient

empowerment through treatments based on

social cognition theory can boost COPD

patients' daily activities.21

Tahereh et al. tested the effectiveness

of a theory-based physical activity intervention

for rural individuals with prediabetes in a

cluster randomized controlled trial. In the rural

area of Ahar, East Azerbaijan Province, Iran, it

was expected that a physical activity

intervention programme based on the social

cognition theory will modify fasting blood

sugar among rural persons with prediabetes,

resulting in a decrease in diabetes incidence.

Conclusion: Our findings suggest the

usefulness of an SCT-based PA intervention in

reducing the likelihood of prediabetes

progressing to diabetes in rural prediabetic

patients. The findings show that a social

cognition theory-based physical activity

intervention for a rural population at risk of

diabetes could be beneficial.22

Limitation of Social Cognitive Theory

• When applying social cognition theory

to public health, it has a number of limitations

that should be considered. Some of the model's

limitations are as follows:

• The theory is disorganised, relying

solely on the dynamic interaction of person,

behaviour, and environment, which may not

always be the case;

• The theory heavily focuses on learning

processes and ignores biological and hormonal

predispositions that may influence behaviours,

regardless of past experience and expectations,

so it's unclear how much each of these factors

influences actual behaviour and if one is more

influential than the other.

• Aside from referencing prior

experience, the theory does not focus on

emotion or motivation. These aspects receive

very little attention.

• Because the idea is so broad, it can be

difficult to fully operationalize.23,24

Implication of social cognitive theory

The social cognitive theory can be used

in a variety of settings and populations as a

theoretical framework. It's routinely used to

help people improve their habits. It can be

particularly useful for examining how

individuals engage with their environment in

rural locations. The social cognitive theory can

be used to better understand how social

determinants of health and a person's previous

experiences impact behaviour change.25,26

Conclusion

Social cognitive theory is a competent

psychological theory that has demonstrated

consistency and clarity between ideas and

propositions. As a result, its use in medical and

nursing research has enabled the development

of middle-range theories, idea derivation, and

understanding of health phenomena, all of

which have contributed to the advancement of

medicine and nursing knowledge. In the design

of some research methodologies, a theoretical

or conceptual framework is not explicitly used.

The purpose of this paper is to focus on

Bandura's social cognitive theory's contribution

5167 Journal of Positive School Psychology

to the field of education, as well as to assist

researchers in understanding the nature of

theoretical and conceptual frameworks, and

how they can be used to help steer a study or be

identified as a result. In the field of education,

social cognition theory has served as a

theoretical foundation for the development of

teaching/learning methodologies for nursing

students. To summaries, social cognition theory

provides a theoretical framework for

understanding various health phenomena in

research, designing interventions in practice,

and implementing advances in medical and

nursing education teaching processes.

Funding:

This research received no specific grant from

any funding agency in the public, commercial,

or not-for-profit sectors

Competing interests:

The authors declare that they have no

competing interests.

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