Academic journal article Adult Learning

Simulation Methodology in Nursing Education and Adult Learning Theory

Academic journal article Adult Learning

Simulation Methodology in Nursing Education and Adult Learning Theory

Article excerpt

Abstract: Simulation is often used in nursing education as a teaching methodology. Simulation is rooted in adult learning theory. Three learning theories, cognitive, social, and constructivist, explain how learners gain knowledge with simulation experiences. This article takes an in-depth look at each of these three theories as each relates to simulation. Pedagogical approaches as well as ties to simulation of each theory zare addressed. Finally, the implications for research and practice in health care and adult education are discussed.

Keywords: adult education, learning theory, simulation

Simulation has been defined by mcGaghie (1999) as "a person, device, or set of conditions which attempts to present [education and] evaluation problems authentically. The student or trainee is required to respond to the problems as he or she would under natural circumstances" (p. 198). The history of simulation stretches back for centuries. The earliest use of simulation can be traced to the fields of military, aviation, and nuclear power (Blackburn & Sadler, 2003; Bradley, 2006; Issenberg, McGaghie, Petrusa, Gordon, & Scalese, 2005). The military has used simulation the longest, dating back to the 18th century (Bradley, 2006). Aviation pioneered the modern day use of simulation in the 1930s (Scherer, Bruce, Graves, & Erdley, 2003). Simulation has been used in these fields due to the fact that training or testing in these areas in the real world would be too dangerous or costly.

Major movements of the late 20th century drove the impetus toward the use of simulation in the medical and nursing communities. Changing clinical experiences, shorter times in training, and working time restrictions created skill deficiencies in medical students (Bradley, 2006; Issenberg et al., 2005). In nursing, educators struggled with questions of how best to prepare competent nurse clinicians and how to adequately assess clinical skill performances (Ebbert & Connors, 2004; Gibbons et al., 2002; Stroud, Smith, Edlund, & Erkel, 1999). Then in 1999, the Institute of Medicine (IOM) published To Err Is Human (Kohn, Corrigan, & Donaldson, 1999), a report that brought patient safety issues to the forefront of health care and education. The report estimated that 45,000 to 98,000 patients die each year in the United States as a result of medical error. Based on this staggering number, the IOM called for systemic change in health care practices and argued that interdisciplinary training should be a top priority in educational institutions. The report highlighted the potential benefits of teamwork and identified simulation as a resource to address the needed reform.

Nishisaki, Keren, and Nadkarni (2007) declared, "Healthcare, especially the complex hospital care required to treat serious diseases, falls into the category of a high-hazard industry like aviation, chemical manufacturing, nuclear power generation, and the military" (p. 226). Simulation provides a safe supportive educational venue that cannot always be attained with live humans (Blackburn & Sadler, 2003; Seropian, Dillman, & Farris, 2007). With simulation, students are able to practice a variety of tasks and skills, and implement knowledge and decision making without the fear of causing harm to the patient. In addition, students attain the acquisition of skills through a genuine life-like environment (Brannan, White, & Bezanson, 2008; Decker, Sportsman, Puetz, & Billings, 2008; Lasater, 2007; Leigh, 2008; Wolf, 2008).

Simulation is now touted as a wonderful methodology to use in teaching and evaluation. One of the reasons for this is because simulation draws on a variety of adult learning theories. But which learning theories best explain and support how students learn from simulation experiences? What is the process of learning that occurs according to these theories? How is simulation rooted in the learning theory? …

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