Learning nursing through simulation: Towards an expansive model of learning

This thesis explores the impact of simulation upon learning for undergraduate nursing students. A brief history of the evolution of pre-registration nurse education and the development of simulation for nursing provide background and context to the study. The conceptual frameworks used for this study draw upon the work of Benner and Sutphen (2007) and Engeström (1994). Benner and Sutphen’s work highlights the complex nature of situated knowledge in practice disciplines such as nursing. They suggest that knowledge must be constantly integrated within the curriculum through pedagogies of interpretation, formation, contextualisation and performance. These pedagogies present a framework, which enhances the understanding of the impact of simulation upon student learning. Engeström’s work on activity theory, recognises the links between learning and the environment of work and highlights the possibilities for learning to inspire change, innovation and the creation of new ideas. His notion of expansive learning offers nurse education a way of reconceptualising the learning that occurs during simulation. Together these frameworks present an opportunity for nurse education to articulate and theorise the learning inherent in simulation activities. Conducted as a small-scale narrative case study, this study tells the unique stories of a small number of undergraduate nursing students, nurse mentors and nurse educators and explores their experiences of learning through simulation. The nurse educators viewed simulation as a means of helping students to learn to be nurses, whilst, the nurse mentors suggested that simulation helped them to determine nursing potential. The students’ narratives revealed that they approached simulation learning in different ways resulting in a range of outcomes: those who were successfully becoming nurses, those who were struggling or working hard to become nurses and those who were not becoming nurses. A theoretical analysis of learning through simulation offers a means of conceptualizing and establishing different perspectives for understanding the learning described by the participants and offers new possibilities towards an expansive approach to learning nursing. The study concludes by examining what this interpretation of learning might mean for nurse education, nursing research and nursing practice