The neurophysiological basis of learning: attention and memory implications for SCI nurses.

Understanding the neurophysiological basis of learning enables nurses working with individuals with spinal cord injury to astutely assess potential for learning. This is particularly relevant when head injury or drug effects influence neurological systems relevant to learning. The neuroanatomical and neurophysiological bases of learning are related to attention, memory, concept formation/abstraction, reasoning, and executive systems. Attention and memory are discussed as they relate to learning in this article. This information is incorporated into an expanded assessment (Ciminaro, Calhoun, & Adams, 1977; Gazzaniga 1979; Lezak, 1983: Mesulam, 1985). More in-depth nursing assessment related to cognitive systems necessary for learning enables nurses to identify intact and impaired cognitive systems and to quantify deficits. Astute assessment is fundamental to planning effective teaching and learning strategies for spinal cord injured persons especially when learning deficits exist, e.g., in head injured persons who have sustained a spinal cord injury. Implications for client and family education derive from an understanding of the normal neurophysiological basis of learning and normal and abnormal assessment findings. Learning is dependent on several cognitive systems--attention systems, memory systems, concept formation/abstraction and reasoning systems, and the "executive" system. Attention and memory systems are discussed in this article, the remainder will be discussed in the next issue. The neuroanatomy and neurophysiology, clinical findings associated with normal and abnormal function, and nursing implications for the nurse working with individuals with spinal cord injury will be explored.