A Conceptual Framework for Simulation in Healthcare Education Submitted by Irwyn Shepherd RN, ICC, B.App.Sci. M.Ed. A thesis submitted in part fulfilment of the requirements for the degree of Doctor of Education College of Arts and Education Victoria University Footscray, Victoria 3011 Australia 2017 i TABLE OF CONTENTS Index.........................................................................................................................................i-v Appendices……………………………………………………………………………………vi List of Tables…………………………………………………………………………………vii List of Figures...........………………………………………………………………………...viii Abstract ...................................................................................................................................... ix Statement of Authorship ............................................................................................................. x Dedication .................................................................................................................................. xi Acknowledgements .................................................................................................................. xii Prologue: Researcher’s perspective ........................................................................................ xiii Chapter 1: Introduction to the Research ................................................................................ 1 Introduction ................................................................................................................................. 1 Background of the study…………………………………………………………………….….1 Significance of the study………………………………………………………………….........5 Research aims………………………………………………………………………………..…5 Research questions……………………………………………………………………………..6 Directions of study……………………………………………………………………………..6 Definitions………………………………………………………………………………….......7 Conceptual framework…………………………………………………………………………7 Simulation……………………………………………………………………………….……..7 Simulation fidelity .................................................................................................................... 10 Definitions of fidelity in simulation………………………………………………………......11 Beyond definitions .................................................................................................................... 12 Providing context ...................................................................................................................... 12 Drivers for the development of simulation education………………………………………...13 Key drivers……………………………………………………………………………………13 Other impacting factors……………………………………………………………………….14 Simulation as a teaching and learning method ......................................................................... 14 Return on investment ................................................................................................................ 15 Conclusion ………………………….......................................................................................18 Chapter 2: Literature review ............................................................................................... 19 Introduction ............................................................................................................................... 19 A review of simulation research and frameworks .................................................................... 19 Search process ………………………………………………………………………………..20 The history of simulation .......................................................................................................... 20 Simulation in education………………………………………………………………….……23 Fidelity in simulation……………………………………………………………………….…34 Conclusion……………………………………………………………………………….……37 ii Chapter 3: Education theories contributing to the Conceptual Framework .................... 38 Introduction ............................................................................................................................... 38 Commentary .............................................................................................................................. 38 Education theory ....................................................................................................................... 39 Conceptual framework .............................................................................................................. 40 Definition……………………………………………………………………………………...40 The educational philosophy underpinning the conceptual framework ..................................... 41 Social constructivism ................................................................................................................ 41 Social constructivism and the study .......................................................................................... 42 Conceptual framework for the study ......................................................................................... 43 Context ……………………………………………………………………………………….43 Rationale ................................................................................................................................... 44 Application considerations........................................................................................................ 45 Theory 1: Adult Learning Theory or Andragogy ............................................................... 47 Rationale ................................................................................................................................... 47 Theory 2: Heutagogy or self-determined learning .............................................................. 49 Rationale ................................................................................................................................... 49 Theory 3: Tacit knowledge .................................................................................................... 50 Rationale ................................................................................................................................... 51 Theory 4: Learning styles / characteristics / preferences ................................................... 52 Rationale ................................................................................................................................... 52 Kolb’s learning styles inventory (LSI) ..................................................................................... 53 Honey & Mumford’s learning styles model questionnaire (LSQ)............................................ 55 Fleming’s visual auditory kinesthetic (VAK) model ................................................................ 56 Theory 5: Experiential learning ........................................................................................... 58 Rationale ................................................................................................................................... 58 Kolb's experiential learning theory and learning styles model ................................................. 59 Kolb's learning styles contextualised within the experiential learning cycle ........................... 61 Situated cognition theory (situated learning) ............................................................................ 64 Theory 6: Critical thinking / clinical reasoning / clinical judgement ................................ 64 Critical thinking……………………………………………………………………………….65 Rationale ................................................................................................................................... 65 Clinical reasoning……………………………………………………………………………..67 Clinical Judgement.................................................................................................................... 68 Theory 7: The reflective learner / guided reflection ........................................................... 69 Rationale ................................................................................................................................... 70 Underpinning theories ............................................................................................................... 71 Andragogy and experiential learning – and reflection .............................................................. 72 Constructive feedback and debriefing – and reflection ............................................................ 73 Reflection variables in simulation ............................................................................................ 74 Debriefing frameworks and models – and simulation .............................................................. 74 Debriefing frameworks and models .......................................................................................... 76 iii Theory 8: Novice to expert theory ........................................................................................ 77 Rationale ................................................................................................................................... 78 Scaffolding ................................................................................................................................ 80 Theory 9: Self-efficacy ........................................................................................................... 82 Rationale ................................................................................................................................... 82 Theory 10: Deliberate practice and acquisition of expert performance ..........................