Social Cognitive Theory, Metacognition, and Simulation Learning in Nursing Education

Social cognitive theory (SCT) postulates that intellectual factors, behavior, and environment exert simultaneous and reciprocal influence over each other and the individual (^{Bandura, 1991} ). Simulation learning encompasses activities on a continuum from simple introductory scenarios requiring response to patient needs during basic hygienic care to situations demanding complex decision making and application of critical care skills. Using SCT as a framework for planning and implementing simulation learning activities not only optimizes task and content mastery but also supports student analysis of one's own learning or thinking process. The focus of this article is to describe how intellectual factors in SCT are influenced during each step in the simulation learning process and to exemplify that theory-based integration of simulated learning supports metacognitive growth of adult learners in an associate degree nursing program.

Faculty create an environment conducive to learning, structure presimulation and postsimulation activities that foster symbolic coding operations, provide the structure for skill rehearsal supporting motor retention processes, and promote self-regulation of behavior and self-efficacy during the simulation and debriefing process. Successful outcomes in the simulation laboratory foster self-esteem. Simulation learning is uniquely suited to promoting student anticipatory control over similar future clinical situations in support of metacognition. Tailoring level of difficulty to participants' mastery level supports successful outcomes that motivate students to set higher personal standards for goal attainment. Human agency is supported by deliberate consideration of the core principles of intentionality, forethought, self-reactiveness, and self-reflectiveness (^{Bandura, 2001} ) in selection of simulated learning activities and facilitation of the debriefing process. Effective integration of simulated learning into the curriculum uses simulation as a teaching method to support course learning outcomes and foster maturation of metacognitive growth to promote self-directed, entry-level practitioners.

Social Cognitive Theory

Social cognitive theory describes learning that is affected by cognitive, behavioral, and environmental factors, which are intricately and reciprocally connected (^{Bandura, 1991} ), to bring about the conscious desire to self-regulate future behavior. Bandura (¹⁹⁶⁹ ) initially focused his research on observational learning through modeling the behavior of others. The four components of observational learning are (a) attentiveness, (b) symbolic coding operations, (c) motor retention processes, and (d) motivation. Intrinsic motivation and external incentives affect attentiveness to the learning environment. Retention of learning occurs...