Introduction: Simulation-based learning is a teaching methodology, which provides the students with a learning opportunity in an environment that simulates the clinical settings, where mistakes and learning can happen without any risk of patient harm. However, despite of its importance, there is a lack of empirical studies about simulation-based learning in the United Arab Emirates. Aim: To explore and describe the perceptions of the nurse educators regarding simulation-based learning in the undergraduate nursing education and the hindering and facilitating factors for effective simulation-based learning in the United Arab Emirates in order to develop strategies for effective simulation-based learning. Research design: A complex mixed method design. Methods: The study design comprised four phases. • Phase one: qualitative exploratory, descriptive, and contextual design, in which purposive sampling was used to collect data from 18 nurse educators working in two nursing colleges in the United Arab Emirates through individual interviews. Data was analysed using thematic analysis with the assistance of NVivo QSR software version 12. • Phase two is a descriptive quantitative design, in which sampling for the entire population was used to collect data from 45 nurse educators working in two nursing colleges in the United Arab Emirates using a modified Simulation Culture Organizational Readiness Survey. Data was analysed with the assistance of the Statistical Package for Social Sciences Software using descriptive and inferential statistics. • Phase three is meta-inferences: where mixing of data from both phase one and phase two was done to guide the process of phase four. The first three phases represent the exploratory sequential mixed method. • Phase four is a modified e-Delphi technique: Purposive sampling was used among academic leaders and the nurse educators in the two nursing colleges, to develop a consensus on the strategies for effective simulation-based learning in the undergraduate nursing education. In this phase, data was collected through emails and online questionnaires. One hundred percent agreement on the proposed strategies granted, which indicated that the participants had reached the consensus. Results and conclusion: Based on the nurse educators and academic leaders’ needs and perceptions, the SBL strategic recommendation developed, these recommendations that are aligned with the international simulation-based learning recommendation and practices. There was evidence between the perceived influencing factors and the utilization of simulation-based learning in the nursing colleges. This study evolved in many implications and recommendation in regard to the strategies for effective simulation-based learning to benefit nursing education. Key terms / concepts: Simulation, Simulation-based learning, Undergraduate nursing education, Strategies, Nurse educators, Effectiveness, Academic leaders. / Thesis (PhD)--University of Pretoria, 2021. / Nursing Science / PhD / Unrestricted

En undersökning om Simulation inom utbildningsområdet, med hjälp av medieteknik. I artikeln diskuteras bland annat hur erfarenhet-baserad undervisning, som en digitalsimulation med fysiska kontroller, kan vara ett utmärkt tillägg för hur man undervisar. Dessutom kan det vara ett sätt att ge en individ mer självförtroende och får hen att mer tänkaundermedvetet hur arbetet kan göras bättre. För att utreda detta har arbetet fokuserat på en typav simulation, nämligen inom truckkörning. Undersökningen har också samarbetat med Volvo Car Body Components för att se vad de upplever som risker inom truckkörning, och vad som då borde fokuseras på en sådan simulation.Simulation har sedan presenterats för deltagare med och utan kompetens i truckkörning, föratt sedan utreda om de känner att de skulle kunnat använda upplevelsen undermedvetet somerfarenhet för framtida strävanden. Det är diskuterbart om resultatet på undersökningen är användbar eller inte, då mängden avdeltagare kunde har varit större. Dock kan det argumenteras för att arbetet gjort ger chansenför flera undersökningar inom simulation-baserad undervisning att kunna visa att bara för ettsätt av utbildning funkar, betyder inte det att det finns det sätt att göra något bättre.

While the body of evidence supporting the use of simulation-based learning in the education of health professionals is growing, howor why simulation-based learning works is not yet understood. There is a clear need for evidence, grounded in contemporary educational theory, to clarify the features of simulation instructional design that optimize learning outcomes and efficiency in health care professional students. Cognitive Load Theory (CLT) is a theoretical framework focused on a learner’s working memory capacity. One principle of CLT is example based learning. While this principle has been applied in both traditional classroom and laboratory settings, and has shown positive performance and learning outcomes, example based learning has not yet been applied to the simulation setting. This study had two main objectives: to explore if the example-based learning principle could successfully be applied to the simulation learning environment, and to establish response process validation evidence for a tool designed to measure types of cognitive load. Fifty-eight novice students from nursing, podiatric medicine, physician assistant, physical and occupational therapy programs participated in a blinded randomized control study. The dependent variable was the simulation brief. Participants were randomly assigned to either a traditional brief or a facilitated tutored problem brief. Performance outcomes were measured with verbal communications skill presented in the Introduction, Situation, Background, Assessment, Recommendation (I-SBAR) format. Response process evidence was collected from cognitive interviews of 11 students. Results indicate participation in a tutored problem brief led to statistically significant differences at t(52)=-3.259, p=.002 in verbal communication performance compared to students who participated in a traditional brief. Effect size for this comparison was d=(6.06-4.61)/1.63 = .89 (95% CI 0.32-1.44). Response process evidence demonstrated that additional factors unique to the simulationlearning environment should be accounted for when measuring cognitive load in simulation based learning (SBL). This study suggests that example based learning principles can be successfully applied to SBL and result in positive performance outcomes for health professions students. Additionally, measures of cognitive load do not appear to capture all contribution toload imposed by the simulation environment.

Embodied conversational agents put a “human” touch on intelligent tutoring systems by using conversation to support learning. When considering instruction in interpersonal domains, such as intercultural negotiation, the development of an interpersonal relationship with one’s pedagogical agent may play a significant role in learning. However, there is conflicting evidence in the literature both regarding the ability of agents to cultivate social relationships with humans, and their effect on learning. In this dissertation, I present a model of social dialog designed to affect learners’ interpersonal relations with virtual agents, a development process for creating social dialog, and empirical studies showing that this dialog has significant effects on learners’ perceptions of the agents and negotiation performance. In early work, I explicitly prompted learners to have social goals for the interaction. I found that while students who reported social goals for interacting with the agents had significantly higher learning gains, explicit prompting was not effective at inducing these goals. I thus focused on implicit influence of learner goals, developing a model of social instructional dialog (SID) that integrates conversational strategies that are theorized to produce interpersonal effects on relationships. In two subsequent studies, an agent with the SID model engendered greater feelings of entitativity, shared perspective, and trust, suggesting that the model improved learner social relationships with the agent. Importantly, these effects transferred to other agents encountered later in the environment. The social dialog condition also made fewer errors and achieved more negotiation objectives in a subsequent negotiation than a control group, evidence that the improved social relationship lead to better negotiation performance. These findings regarding interpersonal relationships with agents contribute to the literature on learner-agent interactions, and can guide the future development of agents in social environments.