Social Learning Theory and Social Cognitive Theory in Healthcare Simulation - A Narrative Review

Area of Science:

• Medical Education
• Psychology
• Simulation-Based Education

Background:

• Social Learning Theory (SLT) and Social Cognitive Theory (SCT) are often applied interchangeably in simulation-based education (SBE).
• Existing research frequently invokes these theories to explain observational learning and the role of observers.
• However, claims of one theory's superiority over the other often lack sufficient empirical support.

Purpose of the Study:

• To critically evaluate the application and distinct contributions of SLT and SCT in healthcare simulation.
• To determine which theory, SLT or SCT, better aligns with contemporary simulation practices, especially concerning observer roles and learner agency.

Main Methods:

• A purposive literature search was conducted across major databases (PubMed, Scopus, CINAHL, ERIC, Google Scholar).
• Relevant foundational texts and empirical studies focusing on healthcare simulation were identified.
• Literature selection criteria included conceptual relevance to modelling, observer roles, self-efficacy, self-regulation, debriefing, and performance transfer.

Main Results:

• SLT effectively explains foundational concepts like modelling and reinforcement in early learning.
• SCT expands on SLT by integrating self-efficacy, self-regulation, and reciprocal determinism, providing a richer explanation for observer learning in SBE.
• Empirical evidence supports directed observation, observer tools, structured debriefing, and error analysis in SBE, aligning with SCT principles.
• No direct comparative studies exist to definitively prove SCT's superiority over SLT in SBE designs.

Conclusions:

• Social Cognitive Theory (SCT) demonstrates strong theoretical alignment with current healthcare simulation practices, particularly for observer roles and enhancing learner agency.
• Despite its theoretical advantages, current evidence positions SCT as a promising framework rather than a proven superior model.
• Further comparative research is essential to rigorously test theory-driven simulation designs and validate SCT's role in SBE.