A Concept Analysis of Conceptual Learning:
A Guide for Educators
Katherine A. Fletcher, PhD, RN, CNE; Vicki L. Hicks, MS, APRN;
Regina H. Johnson, MSN, RN; Delois Meyer Laverentz, MN, RN, CCRN-K;
Christina J. Phillips, DNP, APRN, FNP-C; Lynelle N.B. Pierce, MS, RN, CCNS, CCRN;
Deana L. Wilhoite, MSN, RN; and Jessica E. Gay, MSN, RN, RNC-MNN
ABSTRACT
Background: Concept-based curricula, coupled with
conceptual approach to teaching, fosters conceptual learn-
ing. There is a need for clarity in the definition of conceptual
learning. Method: Walker and Avant’s method of concept
analysis was used. Results: Conceptual learning is a process
in which learners organize concept-relevant knowledge,
skills, and attitudes to form logical cognitive connections re-
sulting in assimilation, storage, retrieval, and transfer of con-
cepts to applicable situations, familiar and unfamiliar. Attri-
butes identified were (a) recognizing patterns in information,
(b) forming linkages with concepts, (c) acquiring deeper un-
derstanding of concepts, (d) developing personal relevance,
and (e) applying concepts to other situations. Antecedents
were (a) learner cognitive potential, (b) organized conceptual
framework, and (c) conceptual approach to teaching. Con-
sequences were (a) enhanced synthesis and analysis, (b) im-
proved problem solving, (c) ability to translate theory to prac-
tice, (d) appreciation of linear/nonlinear ways of thinking,
and (e) enhanced concept construction. Conclusion: This
analysis provides a referent for recognizing the occurrence of
conceptual learning and developing instruments to measure
its outcomes. [J Nurs Educ. 2019;58(1):7-15.]
Dr. Fletcher is Clinical Professor, Ms. Hicks is Clinical Associate Profes-
sor, Ms. Johnson is Clinical Assistant Professor, Ms. Laverentz is Clinical
Assistant Professor, Dr. Phillips is Clinical Assistant Professor, Ms. Pierce
is Clinical Assistant Professor, Ms. Wilhoite is Clinical Instructor, and Ms.
Gay is Clinical Assistant Professor, University of Kansas, School of Nursing,
Kansas City, Kansas.
The authors thank Sally Barhydt, Publication Consultant, University of
Kansas, School of Nursing, for her assistance with editing.
The authors have disclosed no potential conflicts of interest, financial
or otherwise.
Address correspondence to Katherine A. Fletcher, PhD, RN, CNE, Clini-
cal Professor, University of Kansas, School of Nursing, 8953 Hillview Drive,
De Soto, KS 66018; e-mail: kfletche@kumc.edu.
Received: February 5, 2018; Accepted: July 11, 2018
doi:10.3928/01484834-20190103-03
Journal of Nursing Education • Vol. 58, No. 1, 2019
C
oncept-based curriculum design is gaining widespread
use in nursing education. This curriculum design is one
response to the call for reform in nursing education to
address content overload and better prepare nurses for today’s
complex health care environment (Institute of Medicine, 2010).
A concept-based curriculum facilitates both deep understanding
and the ability to apply knowledge to diverse situations through
the process of conceptual learning. However, no common defi-
nition of conceptual learning currently exists. Clarifying the
definition will provide a referent for recognizing conceptual
learning. This article defines conceptual learning using Walker
and Avant’s (2011) approach to concept analysis.
BACKGROUND
In a concept-based curriculum, content is structured around
a defined set of concepts that form a unifying classification
to frame the learning (Giddens, 2017). Concepts are defined
as organizing principles grouped in coherent ways (England,
Lockhart, & Sanders, 2015). Significant educational resources
have been developed to promote the structure of concept-
based curriculum and the conceptual approach to teaching.
The learning outcomes of these structures and processes have
not been identified and are complicated by incongruent terms
in the literature. By defining conceptual learning and its as-
sociated characteristics, a basis will be provided to evaluate
learning outcomes.
Concept Analysis Method
Walker and Avant’s (2011) approach to concept analysis was
used to examine and define the concept of conceptual learning.
With this approach, it is recommended to identify the concept to
be studied, determine the purpose of the analysis, and through
a deep and broad literature review describe the uses of the con-
cept, attributes, antecedents, and consequences. This process re-
lies heavily on the authors’ ability to recognize recurring themes
during an extensive literature search. To contribute to the con-
cept’s clarity, it is important to develop model, contrary, and
borderline or related cases to illustrate the concept (Giddens &
Brady, 2007). As the last step of concept analysis, Walker and
7

Figure 1. Flowchart showing the data selection process.
Avant recommended investigating empirical referents for the
measurement of the concept.
After selecting a concept, the second step for researchers is
to determine the intended purpose of their analysis (Walker &
Avant, 2011). Keeping the outcome in mind while conducting
the analysis will help determine the exact definition and defin-
ing attributes of the concept. For the Kansas University School
of Nursing, the concept analysis of conceptual learning is part
of a quality improvement project to measure the outcomes of
the learners’ educational process using a concept-based curricu-
lum. An evidence-based analysis of conceptual learning will: (a)
provide clarity in the definition and identification of attributes
of conceptual learning to facilitate the design of content within
a concept-based curriculum, (b) explore whether conceptual
learning provides the basis for understanding meaningful learn-
ing such as creative and critical thinking, and (c) provide a basis
to design methods to measure conceptual learning outcomes for
quality improvement and research purposes.
DATA SOURCES
A series of literature searches were performed using the
terms concept based, concept-based learning, concept-based
teaching, concept-based curriculum, concept formation, and
constructivism. An initial search of the literature focused on
nursing education literature in the Cumulative Index of Nurs-
ing and Allied Health (CINAHL®) database, which resulted
in 48 articles from 1990 to 2017. Because the concept-based
curriculum had its origins in kindergarten through 12th grade
(K-12) and postsecondary education, the literature search was
expanded to all education literature with a search of the Edu-
cation Resources Information Center (ERIC™) database from
1970 to 2017. The expanded search identified an additional 51
articles. Inclusion criteria were primary research studies, dis-
8 Copyright © SLACK Incorporated
sertations, and book chapters written in the English language. A
manual search of the reference lists of selected articles also was
conducted for additional sources. The search concluded when
no new records were found that revealed new information re-
lated to definition, attributes, antecedents, and consequences of
conceptual learning.
The initial search identified 103 articles (Figure 1). Af-
ter screening for duplication and applicability for conceptual
learning, 36 records were excluded. A full-text review of the
remaining 67 records was conducted, and an additional 34 re-
cords were excluded. A focus on concept-based teaching and/
or concept-based evaluation methods was reason for exclusion.
Thus, a total of 33 articles and book chapters were selected for
inclusion based on their ability to inform conceptual learning
and the effect on nursing education.
RESULTS
Concept Usage
During this stage of analysis, Walker and Avant (2011) rec-
ommend identifying as many uses of the concept as possible
to improve the richness and utility of the analysis outcomes.
The literature search revealed that conceptual learning is promi-
nent in educational journals and in the Boolean-valued function
found in machine learning associated with artificial intelligence
and library science.
In the literature from artificial intelligence and library sci-
ence, conceptual learning was the term used to describe the
logical functions to classify data (Milne, Witten, & Nichols,
2007). By using concepts, machines sort through data and re-
trieve information when requested. Terms such as and, or, and
not are the primary operations that the machine uses to search
for the data in library science. In artificial intelligence, machine
learning classifies a series of data based on certain given proper-
ties. The machine locates clusters within groups of data using
inductive reasoning, and these clusters represent concepts be-
cause their properties are alike. These definitions of conceptual
learning did not describe the type of learning that occurs within
students.
Many educators across disciplines and educational levels
(K-12 and graduate) have stated they are promoting conceptual
learning. However, these educators have not defined conceptual
learning and often mix terms such as concept-based curricu-
lum, conceptual approach to teaching, and conceptual learning
without explaining the differences in meaning.
Although Giddens, Caputi, and Rodgers (2015), who are the
champions in nursing for concept-based curriculum, discussed
the science of learning in depth, they did not offer a definition of
conceptual learning. Only two definitions of conceptual learn-
ing were found in the nursing literature. Timpson and Bendel-
Simso (2003) described conceptual learning as “the processes
by which students learn how to better organize information in
logical mental structures, how to challenge ideas in light of new
data, and how to reorganize information and hypothesize new
explanations” (p. 36). Arslan (2010) stated conceptual learning
“occurs as a result of a ‘combination’ of existing knowledge,
and it enables individuals to understand and appropriate new
knowledge” (p. 95).
 As the definitions of con-
ceptual learning were ex-
plored, it was evident that
these definitions did not de-
scribe conceptual learning in
a way that would differenti-
ate it from other forms of
learning. To this end, the au-
thors analyzed the literature
and developed the following
theoretical definition of con-
ceptual learning:
Conceptual learning is
a process in which learners
organize concept-relevant
knowledge, skills, and atti-
tudes to form logical cogni-
tive connections resulting in
assimilation, storage, retriev-
al, and transfer of concepts
to applicable situations, fa-
miliar and unfamiliar.

Defining Attributes
The next step in the con-
cept analysis process, ac-
cording to Walker and Avant
(2011), is to determine the
defining attributes of the
concept. Identifying these
defining attributes enables
one to recognize the concept
wherever it appears and to
differentiate it from other
concepts. Defining attributes
are those characteristics of a
concept that appear repeat-
edly in the literature and are
associated most frequently
with the concept (Walker &
Avant, 2011). As the litera-
ture on conceptual learning
was analyzed, certain themes Figure 2. Illustration depicting the conceptual learning analogy.
emerged as descriptions of
conceptual learning. All of
these descriptions were assimilated, and five major themes were ed concept in the same “file cabinet” (Figure 2). Recognizing
identified as the defining attributes of conceptual learning: patterns in the information allows the learner to assimilate and
• Recognizing patterns in information. sort information so it is understandable (Nielsen, 2016). The
• Forming linkages with a concept. best learners often seek patterns on their own, but many learn-
• Acquiring deeper understanding of a concept. ers need to have patterns pointed out to them more explicitly
• Discovering personal relevance and construction of value to (Leonard, Gerace, & Dufresne, 1999).
self. Forming Linkages With a Concept. The second attribute that
• Applying concepts to other situations. is evident in conceptual learning is the ability to form linkages.
Recognizing Patterns in Information. Conceptual learning is This means that the learner can connect the patterns of infor-
a process, and the first attribute noted is that the learner can rec- mation with preexisting conceptual knowledge. Using the fil-
ognize patterns occurring in information as it is received. Using ing cabinet analogy again, this second attribute would be the
an analogy of the brain as numerous “file cabinets,” patterning ability to store all similarly patterned information or facts in
is like placing information or facts that are related to a select- the same “file drawer” labeled with a theme connected to the

Journal of Nursing Education • Vol. 58, No. 1, 2019 9

concept. Memorization of facts that are not put into context is
a basic mental process (Erickson, 2012). It is the connection of
the facts and knowledge to the larger picture that is important
(Giddens et al., 2015). Ausubel, Novak, and Hanesian (1978)
described how new knowledge acquired by learning is not lined
up or stacked on top of previously acquired knowledge but is
integrated with previous knowledge to generate understanding
of new interlocking concepts. Giddens et al. (2015) described
this as extending the neuronal connections.
Leonard et al. (1999) compared the knowledge storage of
experts with that of novices and found that experts have a large
storage of domain-specific knowledge that is richly intercon-
nected. However, even novices have the ability to make linkages
at a beginning level and build on them. Rodehorst and Wilhelm
(2011) referred to these linkages as bridges between what the
learner currently knows and what the learner can learn. A ben-
efit to making these connections is that it leads to deeper per-
sonal inquiry (Erickson, 2012) and helps the learner retain the
information (Rodehorst & Wilhelm, 2011).
Acquiring Deeper Understanding of a Concept. The third de-
fining attribute of conceptual learning is acquiring deeper under-
standing of the concept. The learner in this process uses new and
preexisting knowledge to create a restructured understanding of
the concept (Anderson & Krathwohl, 2001; Arslan, 2010; Guth-
rie, Van Meter, Hancock, Alao, Anderson, & McCann, 1998). Us-
ing the file cabinet analogy, this attribute would be putting all the
new information or facts into already existing file folders with
similar information or making new file folders to hold newly dis-
covered facts connected to the themes of the concept.
Deep understanding of any concept requires the learner to
use different examples of the same knowledge and interrelate
the ideas through personal experience (Leonard et al., 1999).
This clustering of the knowledge from examples to the concept
helps to refine and sharpen the meaning of the concept (England
et al., 2015; Leonard et al., 1999). Giddens and Brady (2007)
discussed the importance of choosing exemplars carefully in a
concept-based curriculum because they help the learner under-
stand the concept. The individual engaged in conceptual learn-
ing will be able to acknowledge the similarities and differences
within and between concepts (England et al., 2015) and develop
a deeper understanding through application of concepts in mul-
tiple contexts (Erickson, 2012).
Discovering Personal Relevance and Construction of Value
to Self. The fourth defining attribute of conceptual learning is
discovering a personal relevance to the concept and construct-
ing value to self. Conceptual learning must have a purpose that
is apparent to the learner. The learner’s perception of the value
of what is being learned influences motivation. This motiva-
tion in turn influences what and how information is learned.
Transferring previous knowledge to a new learning situation is
enhanced by creating a situation in which learners see the value,
the direct relationship to their area of study, and the implica-
tions of why it is important. With this type of application, the
learner can see the benefit while learning (Giddens et al., 2015).
Conceptual learning allows learners to use their own personal
relevance to make connections with the concept so they recon-
struct a new personal reality of that concept and thus increase
its value.
10
Applying Concepts to Other Situations. The fifth attribute of
conceptual learning is applying concepts to situations. Experts
have the skill to retrieve applicable and appropriate knowledge
related to a presenting problem, which is referred to as con-
ditionalized knowledge. Learners use their preexisting experi-
ences or facts that are known to them to make connections and
form relationships while they synthesize new information and
discover further knowledge on their own (Sutherland, 1969).
Giddens et al. (2015) used the term neuroplasticity to describe
the brain’s ability to reorganize and restructure itself though the
formation of new neural connections because of learning expe-
riences.
Related Concepts
After the concept has been clearly defined and its attributes
identified, it can be differentiated from similar concepts (Walk-
er & Avant, 2011). For the concept of conceptual learning, the
authors found a significant semantic problem. Many similar or
congruent terms are used throughout nursing education and the
nursing literature, resulting in much confusion about what gen-
uinely constitutes conceptual learning. A consistent definition
of conceptual learning with standardized attributes and termi-
nology is essential to identify and compare outcomes.
Commonly encountered terms in the literature include con-
ceptual approach to teaching, concept-based curriculum, and
constructivism. The authors believe conceptual learning to be
uniquely defined as a distinct phenomenon that should not be
equated with similar terms or used interchangeably with terms
that have different meanings and characteristics. Standardized
language can provide clear differentiation that is needed in this
emerging area of nursing education. The impetus for this article
was the need to clearly define conceptual learning.
Conceptual learning is the outcome that one would expect
from a learner who has been exposed to a curriculum that uses
a conceptual approach to teaching. Conceptual learning is the
process that happens within the individual who interacts with
the concepts. A conceptual approach to teaching often is de-
scribed incorrectly in the literature as synonymous with con-
ceptual learning when they are actually two separate phenom-
ena. Conceptual approaches to teaching are strategies or actions
used by the teacher to promote conceptual learning.
Constructivism is the process of acquiring knowledge in
which the knowledge is individually constructed and recon-
structed by learners based on their interpretations from world
experiences (Jonassen, 1999). This type of learning is centered
on a big picture idea that students can break down and then
engage in parts of the whole. Through this experience, students
will begin to understand the whole, see personal relevance, and
change their worldview. Like conceptual learning, constructiv-
ism accepts personal relevance as part of the learning process
for every individual. In contrast, however, conceptual learning
uniquely considers pattern information, forming linkages and
applying concepts to familiar and unfamiliar situations as criti-
cal components of learning.
Examination of all the related terms is an essential part of the
concept analysis process to clearly differentiate the definition
and defining attributes of the studied concept. Distinguishing
these related concepts from conceptual learning helps to elimi-
Copyright © SLACK Incorporated
nate confusion and provide clarity in the phenomenon so that it
can be measured.
Constructed Cases
Another necessary step in concept analysis, according to
Walker and Avant (2011), is to construct cases to clearly dem-
onstrate the concept. The authors developed a model case, a re-
lated case, and a contrary case to illustrate the unique definition
and defining attributes of conceptual learning.
Model Case. The following model case is a pure exemplar
because it includes all of the defining attributes of conceptual
learning.
Cassie, a nursing student, learns about the concept of perfu-
sion during a classroom session. Her group examines an exem-
plar case study of a patient with peripheral vascular disease.
They gather data from the case to identify the attributes of
perfusion and formulate a person-centered plan of care. Earlier,
Cassie studied the concept of clotting. She recognizes that per-
fusion is an interrelated concept to clotting, but these concepts
have different attributes. Cassie reflects that her grandmother
experiences pain in her legs, her toes become pale when walk-
ing short distances, and the pain stops once she stops walking.
This is not a clotting problem because the extremity would ap-
pear swollen and the pain would be continuous. Cassie recog-
nizes that her grandmother probably has a perfusion problem
and shares her grandmother’s signs and symptoms with the
group when they talk about patent arterial blood vessels and
adequate blood and hemoglobin as some of the defining char-
acteristics of perfusion.
In the clinical setting one week later, Cassie is assigned a
patient with Raynaud’s disease. She has never cared for a pa-
tient with this diagnosis. In her assessment of the patient, she
notes that the left lower extremity is pale, cool to the touch,
and pulseless. The patient reports pain in his left foot. Cassie
recalls what her small group discussed about perfusion and rec-
ognizes that Raynaud falls within the perfusion concept. Cassie
recalls nursing interventions appropriate for this patient, which
include keeping the left lower extremity in a dependent posi-
tion, applying a warm blanket to the legs, assessing the circula-
tion of the extremity frequently, and informing the primary care
provider of any changes.
In the case of conceptual learning, learners identify pat-
terns in information using concepts as defined by specific at-
tributes. Learners can practice with exemplars of the concept
through case studies and other group classroom activities; in
doing so, learners have an opportunity to experience the con-
cept in a personal way. In this case, Cassie can discern simi-
larities and differences between concepts, revealing linkages
between concepts and existing knowledge. In experiencing the
exemplars of a concept, she attaches personal relevance to the
information, ensuring retrieval of the information when needed.
As Cassie then applies this new connected, linked, relevant
knowledge to a clinical situation, a deep understanding of the
concept is formed. When presented with an unfamiliar situa-
tion, Cassie can anticipate or predict the attributes of this new
exemplar because she recognizes similarities and differences
between known concepts. Retrieval is made easier because of
the deep understanding and personal relevance of the linkages
Journal of Nursing Education • Vol. 58, No. 1, 2019
made within her mind. Also empowering to the learner (Cassie)
is the fact that application of knowledge can be made without
knowing all of the details of the situation (England et al., 2015).
Higher order thinking (Getha-Eby, Beery, O’Brien, & Xu,
2015), as measured over time, increases correlationally as the
learner progresses along the continuum of conceptual learning.
Indeed, Getha-Eby et al. (2015) proposed that the learning out-
comes/consequences of conceptual learning may not be readily
apparent but will develop and strengthen over time.
Related Case. A related case is one in which only some of
the defining attributes are present (Walker & Avant, 2011). The
idea is similar but distinguishable from the concept in question.
When discussing conceptual learning, it is important to distin-
guish it from other related ways of learning, such as construc-
tivism. Studying related concepts ensures that instruction builds
depth of understanding by attending to, and adding to, the lan-
guage of each subject area (Erickson, 2012). The related case
is as follows:
Sean, a nursing student, is in an acute care clinical setting
today. He is assigned a patient diagnosed with thrombophlebi-
tis. At the preconference meeting, Sean stated, “My grandfather
had a clot in his leg and developed a breathing problem, and he
had to be admitted to the hospital intensive care unit. He had to
be on blood thinning drugs for a long time after that. I know that
I will probably have to keep this patient on bed rest and assess
for shortness of breath because that could be a complication for
this patient. I also had a patient with this problem last semester,
and I remember that he complained of aching pain in his leg, so
I need to assess for pain.” Sean recalled his classroom exemplar
and remembered that he might need to keep the leg elevated to
decrease the swelling and pain.
In this case, the learning theory of constructivism is like con-
ceptual learning in that it is based on the notion that learning is
experiential and cannot be divorced from previous experiences.
The Business Dictionary (n.d.) describes constructivism as a
teaching philosophy in which “each student creates his or her
own ‘schemas’ or mental-models to make sense of the world,
and accommodates the new knowledge (learns) by adjusting
them.” As illustrated in this related case, the individual is seen
as responsible for constructing knowledge based on previous
experiences and assimilation of new information, encompass-
ing the learner’s past and present (constructivism). Conceptual
learning takes the learning one step further, creating transfer of
knowledge to future unknown situations and contributes to fu-
ture responses of the learner. Giddens, Wright, and Gray (2012)
stated that “development of conceptual thinking skills helps
learners recognize certain aspects of the presenting condition
and attain a general understanding of what to do” (p. 512). This
is different from Sean’s case in which he relies heavily on his
previous experiences rather than conceptual knowledge. When
placed in a situation that he has never experienced before, Sean
most likely will rely on past experiences and may have difficul-
ty differentiating the patient’s clinical problem and determining
appropriate actions.
Contrary Case. A contrary case is one in which none of the
defining attributes are present and is often the opposite of the
phenomenon—conceptual learning—being described (Avant &
Walker, 2011). A contrary case to conceptual learning is factual
11
learning or memorization that focuses on facts or sequences
of events and memorization of specifics or operations (Arslan,
2010). When the learner simply memorizes a fact and then tries
to recall the fact, it must be requested in the exact form it was
memorized to be recognized. If the examination item or practi-
cal situation is not exactly the same as the memorized statement,
the learner may have difficulty choosing the correct response
or action. The learner’s ability to recognize patterns within in-
formation is not cultivated in the action of rote memorization.
In this type of learning, no personal meaning or relevance is
attached to the fact. No experience with the information has oc-
curred to link it to long-term and preexisting knowledge. Mem-
orization does not create deep understanding because context is
often absent. Because no meaning is attached to the information
memorized, it only can be retrieved for a short period of time.
Over the long term, information is lost. Information is not ap-
plied to situations and therefore has no staying power; unrelated
facts are quickly forgotten. The contrary case is as follows:
Molly, a beginning nursing student, has performed well on
section exams due to a practiced skill of memorizing impor-
tant facts taught in class. In the clinical setting today, she is
assigned a patient who is experiencing peripheral arterial dis-
ease. Molly recalls from a recent pathophysiology lecture and
nursing foundations class that there are five Ps that indicate the
symptoms of peripheral arterial disease. When preparing for her
morning assessment, Molly tells the clinical instructor that she
will examine the patient’s pain, pallor, paresthesia, poikilother-
my, and pulselessness. Several weeks later, Molly encounters
a patient with a peripheral vascular problem but when asked
about typical signs and symptoms of this disease, Molly is un-
able to recall any, stating, “I haven’t studied this condition be-
fore in class, so I don’t know the symptoms.”
Arslan (2010) stated, “Procedural learning (memorizing op-
erations) does not guarantee conceptual learning (understand-
ing and interpreting concepts), but conceptual learning supports
procedural learning” (p. 105). Therefore, when the conceptual
learner recognizes a learned concept in a new situation, that
learner also can predict the correct procedural response required
in the new situation.
In this case, Molly recently memorized the information re-
lated to this patient’s specific disease. Over time, Molly may
well forget what to do, since she may not encounter another
patient with this disease for some time. In addition, Molly has
learned how to respond only to this specific disease or diagno-
sis and has memorized the response to this situation alone. The
factual learning that has served Molly well in the past is not up
to the task of managing this unknown situation. In the case of
conceptual learning, Molly would have knowledge that could
be applied more broadly to similar patient problems that include
similar concepts to those she has learned.
Learners who learn conceptually develop the ability to think
like scientists rather than solely remembering information
(Smith & Zeng, 2004). The learner uses multiple ways of know-
ing by using a set of concepts and their interrelationships to
solve problems (cases) versus depending on rote memorization.
Good clinical judgment would be recognized in the form of im-
proved problem solving skills that would move the individual
from novice to expert as new knowledge is gained (Leonard et
12
al., 1999; Smith & Zeng, 2004). This type of outcome would
be recognized as the learner being able to translate and make
cognitive connections from theory to practice and not simply
memorizing facts (Deane & Asselin, 2015).
Antecedents and Consequences
The next step in concept analysis is identifying the anteced-
ents and consequences that occur around the concept (Walker
& Avant, 2011). Antecedents are the processes that precede the
concept, in this case that precede conceptual learning.
Antecedents. The literature on conceptual learning was ana-
lyzed through an iterative process, and three antecedents were
found to be essential for conceptual learning to occur: learner
cognitive potential, an organized conceptual framework, and a
conceptual approach to teaching.
Learner cognitive potential. The first antecedent, learner
cognitive potential, begins forming at birth. This includes the
learner’s intellect and experiences, previous learning, motiva-
tion, and mental operations and processes. The learner brings
intellect and experiences to the conceptual learning environ-
ment. Johnson (1996) identified intellectual skills as “mental
operations that enable us to acquire new knowledge, apply that
knowledge in both familiar and unique situations, and control
the mental processing that is used to acquire and use knowl-
edge” (p. 2). An individual learner’s motivation, intellect,
and prior life experiences will vary and influence the way the
learner views learning. To build on intellect and life experi-
ence, learners bring previous learning and existing knowledge
of concepts to the learning situation (Arslan, 2010; Leonard
et al., 1999). All learners come with an existing mental struc-
ture that allows them to organize and pattern information
(Leonard et al., 1999). This existing mental structure of con-
ceptual knowledge is the previously mentioned file cabinet.
When learning occurs, the learner organizes new knowledge
in the brain into file drawers that match existing patterns. The
learner can reorganize the file drawers or files at will as new
knowledge is discovered.
Organized conceptual framework. The second anteced-
ent, an organized conceptual framework with clearly defined
concepts, must be present. An organized framework provides
structure that learners and faculty use to pattern their mental
processes; this allows learners and faculty to have the same-
shared mental model in learning environments. Giddens and
Brady (2007) stated “the need for universal understanding and
consistent use of concepts among faculty is critical for curric-
ulum success” (p. 67). Giddens et al. (2012) noted “a process
for the selection of concepts, competencies, and exemplars on
which to build courses and base content is needed” (p. 511). In
addition, clear definitions of concepts allow learners to iden-
tify a concept when encountered and recognize when it is not
present. Gavalcante, Newton, and Newton (1997), in a study
of 9- to 10-year-old children, found that students who had the
greatest gains in conceptual understanding were those who
were provided clear mental structures of the concepts prior to
the teaching.
Conceptual teaching approach. The third antecedent is a
conceptual approach to teaching. Although an organized con-
ceptual framework and clearly defined concepts are necessary
Copyright © SLACK Incorporated
to support conceptual learning, it also is essential to have a con-
ceptual approach to teaching. This type of instruction typically
involves the introduction of a concept, presentation of exemplars
of the concept, and application of the concept (Giddens, 2008).
Using exemplars of a concept allows cognitive connections to
be formed and learning to be retained so that it becomes retriev-
able and applicable to new situations (England et al., 2015). The
concept and its defining attributes help learners recognize the
concept’s presence and absence using exemplars. A conceptual
approach to teaching also is characterized by instructional ac-
tivities that are learner centered, actively engaging the learner
and focusing on making cognitive connections from previous
to new knowledge and from theory to practice (Deane & As-
selin, 2015). Even a well-designed concept-based curriculum
would not be successful unless the faculty embrace conceptual
learning (Giddens & Brady, 2007). A key to the success of the
enhanced environment is a faculty committed to and actively
practicing a conceptual approach to teaching.
Consequences. The consequences or outcomes are those
events that emerge as a result of the occurrence of the concept
(Walker & Avant, 2011). The literature addressing conceptual
learning was examined, and five major outcomes or conse-
quences of conceptual learning emerged: enhanced synthesis,
reasoning, and analysis skills; improved problem-solving skills;
ability to translate theory to practice; appreciation of linear and
nonlinear ways of thinking; and enhanced concept construction.
Enhanced synthesis, reasoning, and analysis skills. The
first consequence of conceptual learning is enhanced synthe-
sis, reasoning, and analysis skills (Giddens, 2013; Lasater &
Nielsen, 2009; Nielsen, Noone, Voss, & Matthews, 2013). With
enhanced understanding of the concept, learners transfer the
knowledge about the concept and make meaningful applica-
tions during problem solving activities. The mastery and ap-
plication, deep thinking, and transferable understanding enables
learners to appreciate new knowledge that links theory to prac-
tice (Arslan, 2010). As a result, learners are more satisfied as
they integrate knowledge more quickly and will gain command
of more elements, features, and functions in a particular domain
(Guthrie et al., 1998).
Improved problem-solving skills. The second consequence
associated with conceptual learning is improved problem-
solving skills. In conceptual learning, those who have gained
a deeper understanding of the concepts tend to have sharper
thinking and reasoning skills and can identify commonali-
ties among exemplars and concepts. This deeper understand-
ing allows learners to connect new knowledge with previously
learned knowledge (Fromer, 2013) and to recognize patterns
and links beyond a diagnosis. The learner’s development of
conceptual thinking skills helps with the recognition of certain
aspects of the presenting condition to attain a general under-
standing of what to do (Giddens et al., 2012). The use of key
concepts prevents an overreliance on memorization of facts as
the end goal. The focus shifts from memorization, which is a
lower form of mental engagement, to deeper, personal inquiry
as learners consider connections between the facts and the key
concepts in reaching sound clinical judgment.
Ability to translate theory to practice. The third conse-
quence of conceptual learning is the ability for learners to trans-
Journal of Nursing Education • Vol. 58, No. 1, 2019
late theory into practice. Use of conceptual learning is intended
to deepen learners’ thinking, pattern recognition, appreciation
of practice outcomes and lifelong learning, and develop key
skills related to clinical outcomes (Giddens et al., 2012; John-
son, 1996; Nielsen et al., 2013). Learners with a well-organized
knowledge of concepts can apply theoretical knowledge faster
using critical thinking in the practice arena (Bransford, Brown,
& Cocking, 1999). This deep understanding allows learners to
creatively apply the theoretical knowledge to relevant practice
situations.
Appreciation of linear and nonlinear ways of thinking.
The fourth consequence of conceptual learning is the appreci-
ation of linear and nonlinear ways of thinking. On initial entry
into the learning process, the learner has years of prior ex-
periences that come with emotional attachment to an already
formed worldview (Leonard et al., 1999). Conceptual learning
requires the learner to become an active participant in sharing
these lived experiences and perspectives that become a filter
for interpreting all learning experiences (Leonard et al., 1999).
As new concepts and constructs are introduced to a learner, it
may be difficult for the learner to identify what features are
most relevant based on his or her prior worldview. However,
as new knowledge is introduced, new patterns and ways of
knowing are created. The learner’s prior worldview begins to
filter experiences through the new concepts, which affects all
interpretations of subsequent experiences and observations.
The learner begins to build useful knowledge structures that
embrace both linear and nonlinear ways of thinking, which
allows the learner to see how a concept manifests itself in a
variety of different ways. Linear and nonlinear ways of think-
ing help the learner become an engaged and active participant
in sharing various perspectives while simultaneously hearing
the cumulative perspectives of others, thus changing previous
learning patterns into restructured and reorganized constructs
that yield a more global and generalizable application (Bran-
don & All, 2010).
Enhanced concept construction. The fifth consequence
of conceptual learning is enhanced concept construction. An
enhanced inductive, lifelong pattern of concept construction
is created through faster and deeper understanding of the
concept, a continual transfer and connection of new knowl-
edge with previous knowledge, and improved higher order
thinking (Fromer, 2013; Getha-Eby et al., 2015). According
to Erickson (2012), this type of learning “builds depth of un-
derstanding by attending to, adding to the language” (p. 17)
of the concepts over time. Learners take new factual knowl-
edge and integrate it with previous knowledge of the concept
by creating a new depth of understanding that builds breadth
and application of the concept, allowing new learning to
be applied to new situations more quickly. This process of
higher order thinking contrasts with a lower level thinking in
which learners who are taught a skill often fail to recognize
that this new skill can be used later to solve similar problems
(Johnson, 1996).
Empirical Referents
In the final step of concept analysis, Walker and Avant
(2011) recommended identifying the empirical referents (i.e.,
13

examples or instruments) found in the literature that can be
used to describe or measure the concept. This is important
because it allows the researcher to observe and measure the
concept, as it exists in the world. The authors were unable
to find any empirical referents in the literature for conceptual
learning, exemplifying the need for further work. A future ap-
plication of this concept analysis would be to use this informa-
tion to construct and test instruments that would measure the
concept.
LIMITATIONS
The purpose of this concept analysis was to develop a com-
mon definition of conceptual learning for faculty. A limitation
of this concept analysis is that it has been conducted by nurse
educators who practice within the framework of a concept-
based curriculum and who use teaching strategies that pro-
mote conceptual learning. Because of their perspective, these
authors have biases that may favor this form of teaching and
learning.
CONCLUSION
This concept analysis provides a comprehensive overview
of conceptual learning by providing a definition, describing
its uses, attributes, constructed cases, antecedents, and conse-
quences. Conceptual learning is complex and therefore not eas-
ily measured, and it is important to know if conceptual learning
is occurring. This concept analysis will assist educators in un-
derstanding how learners conceptually learn, provide a refer-
ent for recognizing when conceptual learning is occurring, and
form the basis for the development of instruments to measure
conceptual learning and its outcomes. A definition of conceptu-
al learning ensures consistent application in research and prac-
tice that promotes standardization, thereby reducing variation
and incomplete application of this type of learning.
An understanding of conceptual learning is essential because
many nursing programs are moving toward a concept-based
curriculum to address content overload in nursing education.
Because conceptual learning promotes enhanced synthesis,
improved reasoning, and analysis skills, as well as increased
problem solving within nursing education, the Institute of Med-
icine’s (2010) recommendation was addressed to prepare learn-
ers to face the challenges of working in complex health care
environments. A consistent commitment to conceptual learning
will improve the competence of graduate nurses and their abil-
ity to translate theory into practice, which in turn will have a
lasting significant impact on health care.
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