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

Social learning theory (SLT) and social cognitive theory (SCT) are frequently invoked in simulation-based education (SBE), particularly when explaining observational learning and the educational value of observer roles. However, the theories are often treated as interchangeable, and conclusions about the superiority of one theory over the other have occasionally exceeded the available evidence.

Foundational theoretical texts and empirical literature relevant to healthcare simulation were identified through purposive literature searches of PubMed, Scopus, CINAHL, ERIC, and Google Scholar, supplemented by citation chaining. Literature was selected for conceptual relevance to modelling, observer roles, self-efficacy, self-regulation, debriefing, and performance transfer.

SLT and SCT share an observational-learning lineage but are not identical. SLT most clearly explains modelling, imitation, and reinforcement during early behaviour acquisition. SCT extends this account by incorporating self-efficacy, forethought, self-regulation, and reciprocal determinism, making it especially useful for understanding how observers interpret, monitor, and transfer learning in SBE. Available empirical work supports the educational value of directed observation, observer tools, structured debriefing, collaborative interpretation, and explicit discussion of errors. Nevertheless, no head-to-head trials directly compare SCT-informed with SLT-informed simulation designs.

SCT appears theoretically well aligned with contemporary healthcare simulation, particularly for observer roles and learner agency, but current evidence supports it as a promising framework rather than a demonstrated default or superior theory. Comparative, theory-driven studies are now needed.