NUR 685 Module 4 Learning Theory Paper Example

Adult and Experiential Learning Theory as the Design Logic for a Sepsis Simulation Course

[Student Name]

Southern New Hampshire University

NUR 685: Nurse Educator Capstone

Module Four Learning Theory Paper

[Instructor Name]

[Date]

Adult and Experiential Learning Theory as the Design Logic for a Sepsis Simulation Course

A learning theory earns its place in a teaching project only if it changes what the educator does. Three theories of adult learning underpin the four-hour sepsis simulation course planned for the residency, and this paper traces how each one shapes it. For each, it explains the core ideas, shows how they fit the learners described in the needs assessment and identifies the parts of the course the theory shapes. It closes with the tensions among the theories and how the design resolves them.

Why Adult Learning Theory Fits These Learners

The residents are licensed adults with licensure, clinical responsibility and a growing store of experience. Taylor and Hamdy (2013) reviewed theories that explain how adults learn in health professions education, grouping them into families that emphasize behavior and cognition, experience, humanistic motivation, transformation of assumptions and social participation. They argued that no single theory explains all learning, and that educators should choose theories that fit the learners and the goal. Three of the families fit this course especially well because the goal is not new knowledge but a change in what residents do under uncertainty.

Andragogy: Learning from Real Problems

Knowles's andragogy, as Taylor and Hamdy summarize it, treats grown learners as people who expect a reason before they invest effort, who carry a reservoir of experience worth tapping, who become ready to learn when a real task demands it, who think in terms of problems more than subjects and who respond to inner drive more than to grades. The residents fit this profile. Several described in the focus group a specific night when they hesitated to call; those moments are more powerful than any case written by an educator.

The theory shapes three parts of the course. The briefing opens with the chart review data, answering the question of why the course matters. Scenarios are built from anonymized versions of residents' own near misses, gathered in the needs assessment. And residents choose one practice change at the end of the day, since adults commit to goals they set themselves.

Experiential Learning: The Structure of Each Scenario

Kolb's experiential learning theory, also reviewed in the guide, describes learning as a cycle. A learner has a concrete experience, reflects on it, forms or revises general ideas from that reflection and tests those ideas in new situations, which begins the cycle again. Learning is incomplete if any stage is skipped: experience without reflection produces habit, and theory without experience produces the gap between the residents' post-test scores and their practice.

Each scenario follows the cycle. The simulated patient is the concrete experience. Debriefing supplies reflection, as residents describe what they noticed and when they decided. The facilitator then helps the group build a general principle, for example that two borderline findings plus a change in mentation meet criteria and warrant a call. The next scenario lets residents test that principle under different conditions, at night with an unfamiliar physician. Three scenarios in one day allow the cycle to turn three times.

Transformative Learning: Unsettling Assumptions

Mezirow's transformative learning, the third family Taylor and Hamdy describe, holds that adults change deeply when an experience conflicts with their assumptions, a disorienting dilemma, and they critically examine and revise the frames through which they interpret the world. The residents carry an assumption that waiting for a second reading is careful and safe. The third scenario is designed to challenge that: if the resident waits, the patient deteriorates into septic shock. Debriefing then examines the assumption itself, not only the action.

This approach carries risk for new graduates. Duchscher (2009) found that new nurses in their first months often feel overwhelmed and self-critical. A scenario that ends badly could deepen that doubt. The design therefore guarantees psychological safety in the briefing, ensures every resident experiences a successful escalation in an earlier scenario and frames the deterioration as a system lesson rather than a personal failure.

Reflection and Clinical Judgment

Tanner (2006) placed reflection at the heart of clinical judgment: reflection during action helps a nurse adjust in the moment, and reflection after action builds the practical knowledge that shapes future noticing and interpreting. She noted that nurses develop judgment largely through this kind of reflection on experience. The course's debriefings are therefore not optional add-ons but the main site of learning, and the closing activity asks each resident to describe one decision point they will handle differently, a structured reflection-on-action.

To support that reflection, each debriefing will follow the phases of Tanner's model in order: what the resident noticed first, how they made sense of it, what they did and when, and what they would now do differently. Walking through the phases in sequence helps residents see exactly where their hesitation began.

Theory Map

Table 1 summarizes how each theory shapes the course. The theories do not compete; they operate at different levels, with andragogy shaping motivation and content, experiential learning shaping the sequence and transformative learning shaping the most challenging scenario.

Table 1. Theories and Course Elements

Note. Theories are drawn from the adult learning review and Tanner's model.

Tensions and Limits

The theories pull in slightly different directions. Andragogy favors learner control, while simulation scenarios are scripted by the educator. The design resolves this by letting residents shape scenarios through their near misses and choose their practice goals. Transformative learning seeks discomfort, while new graduates need safety; the course sequences success before challenge. The theories also say little about transfer from simulation to the floor, which the evaluation plan will measure directly rather than assume.

Conclusion

Three adult learning theories and a model of clinical judgment give the course its logic: real problems for motivation, repeated cycles of experience and reflection for skill and a carefully safeguarded challenge to shift assumptions. The next milestone reviews the evidence for simulation itself.

References

Duchscher, J. E. B. (2009). Transition shock: The initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65(5), 1103-1113. https://doi.org/10.1111/j.1365-2648.2008.04898.x

Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211. https://doi.org/10.3928/01484834-20060601-04

Taylor, D. C. M., & Hamdy, H. (2013). Adult learning theories: Implications for learning and teaching in medical education: AMEE Guide No. 83. Medical Teacher, 35(11), e1561-e1572. https://doi.org/10.3109/0142159X.2013.828153