Running Head: SIMULATION EDUCATION FOR NEONATAL NURSES

concepts from which new implications for action can be drawn. These implications can be actively tested and serve as guides in creating new experiences” (Kolb, Boyatzis & Mainemelis, 2001, pg. 230). This is a student-centered approach (LeFlore & Anderson, 2008) that is well suited for use with high-fidelity simulation (Yaeger & Arafeh, 2008). Kolb’s theory 2 Note: the underlined words are a direct reflection of the cited text SIMULATION EDUCATION FOR NEONATAL NURSES 38 places an emphasis on the learner’s previous experiences that are brought with them to the educational forum (LeFlore & Anderson, 2008), as well as the importance of learning through participation (Fawke & Cusack, 2011; LeFlore & Anderson, 2008), and reflection about the learning experience (LeFlore & Anderson, 2008; Lindamood & Weinstock, 2011). Kolb’s theory is important for educators, as it can enhance the learning that occurs. Kolb contends that educators can achieve the enhancement of learning by creating “learning spaces that promote growth producing experiences for learners” (Kolb & Kolb, 2005, p. 205) and must match their instructional method with the learning style of the students (Kolb, Boyatzis & Mainemelis, 2001). Educators must also “provide the opportunity for reflection on and meaning making about experiences that improve the effectiveness of experiential learning” (Kolb & Kolb, 2005, p.208). These are all important cornerstones of the high-fidelity simulation experience. Although not as extensively cited as Kolb’s Experiential Learning Theory or Adult Learning theory, three other theories were also discussed in the literature as frameworks that might be used for high-fidelity simulation education for neonatal nurses. Bloom’s Taxonomy which depicts learning as evolving from the lowest level of critical thinking to higher cognitive complexity was cited (Yaeger & Arafeh, 2008; Yaeger et al., 2004). It was asserted that traditional education requires learners to simply think at the lowest level (Yaeger & Arafeh, 2008; Yaeger et al., 2004), whereas high-fidelity simulation provides an opportunity to think at a higher level including analysis, synthesis and evaluation of the content (Yaeger & Arafeh, 2008; Yaeger et al., 2004). Kolb’s theory could be thought of as subset of Bloom’s Taxonomy, as Kolb augments and expands on the process by which learning is achieved at the highest level of cognitive complexity as described by Bloom. In one article, Bandura’s Social Learning Theory was used as a framework for highSIMULATION EDUCATION FOR NEONATAL NURSES 39 fidelity simulation for neonatal nurses (LeFlore & Anderson, 2008). In this theory, it is hypothesized that new knowledge is gained though observation and modeling of behaviors, attitudes and emotional reactions (LeFlore and Anderson, 2008). This theory could be a useful framework for high-fidelity simulation, as learners are able to observe and model the successful actions of their peers, incorporate these into their current understanding and develop new knowledge. This parallels constructivist theory. Dreyfus’ Model of Skill Acquisition was also cited as a framework that works well with high-fidelity simulation (Fawke & Cusack, 2011). In this model, students learn skills by deliberate, repetitive practice. The student’s progress from novice to expert is followed and it is asserted that, with the use of high-fidelity simulation, the time to reach the “expert” standing is shortened (Fawke & Cusack, 2011). This model is akin to constructivist theory, in that students are able to continually build on previous knowledge, through repetitive practice, and are able to use this new knowledge to increase their standing from novice to expert. High-Fidelity Simulation and Constructivist Theory Although not explicitly stated in any of the articles, the theoretical frameworks used to describe high-fidelity simulation all have similarities and components of constructivist theory. Similarities among the theoretical frameworks cited within the articles reviewed, constructivist theory, and high-fidelity simulation are summarized in Table 2. In particular, each framework cited requires a student-focused learning environment to enhance learning and understanding, a central feature of both high-fidelity simulation and constructivist theory (Peters, 2000). Another parallel among high-fidelity simulation, constructivist theory and each framework cited is the assumption that learners bring previous life experiences and prior SIMULATION EDUCATION FOR NEONATAL NURSES 40 knowledge to their learning and that learners are internally motivated and self-directed (Peters, 2000; Young & Maxwell, 2007). Another similarity among the frameworks cited, constructivist theory and the debriefing aspect of high-fidelity simulation is that each takes “into account what individual students have learned and how they have learned it” (Peters, 2000, p.166). Further, the success of high-fidelity simulation supports the constructivist theory that students learn best when placed into experiences that challenge their current understanding, can be reflected upon, and from which knowledge can be gained (Peters, 2000; Young & Maxwell, 2007). This is an aspect that is also common to all the frameworks cited. Table 2: Similarities among high-fidelity simulation, constructivist theory, and theoretical frameworks cited H ig h -f id el it y