The purpose of this systematic analysis of nursing simulation literature between 2000 2007 was to determine how learning theory was used to design and assess learning that occurs in simulations. Out of the 120 articles in which designing nursing simulations was reported, 16 referenced learning or developmental theory as the basis of how and why they set up the simulation. Of the 16 articles that used a learning type of foundation, only two considered learning as a cognitive task. More research is needed that investigates the efficacy of simulation for improving student learning. The study concludes that most nursing faculty approach simulation from a teaching paradigm rather than a learning paradigm. For simulation to foster student learning there must be a fundamental shift from a teaching paradigm to a learning paradigm and a foundational learning theory to design and evaluate simulation should be used. Examples of how to match simulation with learning theory are included.
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