Graphics Programs Reference
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understanding from direct experience (Grant &
Marsden, 1992). Problem-based simulation may
be considered a form of experiential learning,
as it based on the idea that concrete experience
provides a basis for observation and reflection,
suggesting that learning through observation and
interaction with a simulated environment will al-
low the student to make illuminating discoveries
and develop a superior cognitive understanding, as
opposed to simply reading about a problem from
a book. In the words of Kolb, “Knowledge results
from the combination of grasping and transforming
experience” (p. 41); he further explains how the
learner's observations and reflections are refined
and assimilated into abstract concepts that can be
applied to new experiences. In other words, the
learning arising out of a simulation can be actively
tested and refined, and in turn result in new experi-
ences and the formation of new understandings.
Role-play is another related strategy that has
become a popular form of creating simulated
clinical experiences for healthcare students. It
allows learners to assume and act on the behav-
iors of a particular character, with minimal risk
involved (McLaughlan & Kirkpatrick, 2004). A
simulation that requires students to play a role
for a specific purpose encourages them to apply
sets of interests, values, and knowledge specific
to the profession, thereby allowing them to ex-
perience and learn the adopted role in a safe,
non-threatening environment (McLaughlan &
Kirkpatrick, 2004). Johnson, Zerwic, and Theis
(1999) conducted a study involving the imple-
mentation and qualitative evaluation of a video-
taped role-play by senior level nursing students
recreating a realistic clinical situation. Through
observation and feedback from the participants, the
authors found that simulating clinical experience
through role-play assisted students in building on
prior knowledge, retaining new knowledge, and
relating the simulation scenario to real clinical
problems, in addition to contributing to the further
development of their critical-thinking skills and
problem-solving abilities.
Numerous studies have been conducted whose
findings attest to the effectiveness of using con-
structivist methods such as PBL, experiential
learning, and role-play to actively engage health-
care students in activities whose the focus is on the
learners as constructors of their own knowledge,
in authentic contexts that are cognitively similar
to those in which the knowledge would be applied
(Barron et al., 1998; Hickey, 1999).
A similar experiment conducted by Alinier,
Harwood, Gordon, and Hunt (2006) presented re-
sults which determined the effect an intermediate-
fidelity scenario-based simulation can have on
healthcare students' clinical skills and competence.
As well as the learning material provided to the
control group, the experimental group was exposed
to an intermediate-fidelity scenario-based simula-
tion that required students to work in small teams
to solve problems based on real-life situations.
By comparing pre- and post-test results the study
found that the experimental group improved their
performance on an Objective Structured Clinical
Examination by almost twice as much compared
with the control group. The difference between the
mean scores was statistically significant, indicat-
ing that simulation is a useful training technique
as it enables healthcare students to practice skills
and obtain hands on experience in a safe and
controlled environment as well as build capacity
in terms of non-technical skills such as teamwork
and communication.
Research in educational theory supports the
constructivist view that students learn more ef-
fectively by engaging in collaborative problem
solving activities and that technology plays a major
role in developing the ways in which students ac-
cess, assess, and integrate new information and
acquire knowledge (Hanson & Sinclair, 2008).
Hanson and Sinclair propose that the purpose of
a learning activity is not so much the problem
being solved, but the learning experience which
helps students develop a cognitive understanding
“that may be generalized beyond the specific
problem” (p. 3).
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