Understanding Deep Cognitive Learning in Medical Simulation

Understanding Deep Cognitive Learning in Medical Simulation

With advancements in technology, healthcare simulation has evolved beyond psychomotor skills training to include deep cognitive learning, which involves higher-order cognitive processes such as critical thinking, decision-making, and problem-solving. One crucial aspect of deep cognitive learning in healthcare simulation is the emotional response of the participants, as emotions play a significant role in the learning process. This HealthySimulation.com article explores the link between deep cognitive learning and emotional responses in clinical simulation, and offers some tips on how to effectively manage participants’ emotions to facilitate meaningful learning connections.

The Science Behind Emotions and Learning

Emotions are complex psychological responses that influence our thoughts, behaviors, and experiences. Research indicates that emotions can impact the learning process and influence attention, memory, and motivation. Emotions can either enhance or hinder learning, based on their valence (positive or negative) and intensity.

Emotions are processed in the brain through the limbic system, which includes the amygdala, hippocampus, and hypothalamus. The amygdala, in particular, plays a crucial role to process emotions and is responsible for the “fight or flight” response. When participants experience strong emotions during a simulation, the amygdala can be activated, which increases arousal and stress levels. This, in turn, enhances the participants’ learning ability to process information and make deep cognitive connections between the experience and the emotional response.

Deep Cognitive Learning: Going Beyond Skills Training

Deep cognitive learning in medical simulation goes beyond the acquisition of psychomotor skills. Deep cognitive learning involves higher-order cognitive processes engagement, such as critical thinking, problem-solving, and decision-making, to promote clinical reasoning and judgment. Deep cognitive learning allows participants to apply their knowledge and skills in complex and dynamic scenarios that mimic real-world clinical situations to enhance clinical competence and improve patient care.

The emotional response of participants involved in simulation is crucial as the response has the ability to engage critical thinking and decision-making processes. For example, high levels of stress or anxiety can impair participants’ cognitive function and negatively impact their performance in the simulation. On the other hand, positive emotions such as curiosity, interest, and excitement can enhance participants’ motivation and engagement, which leads to better learning outcomes.


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Managing Participants’ Emotions for Effective Learning Connections

Healthcare simulation facilitators must have an awareness of the emotional responses of participants and actively manage them to facilitate meaningful learning connections. Here are some tips on how to effectively manage participants’ emotions during deep cognitive learning in healthcare simulation:

Create a Supportive Learning Environment: Establish a safe container for learning to allow participants to feel comfortable to express their emotions and concerns. Encourage open communication and create opportunities for debriefing and reflection to process emotional experiences in the simulation.

Set Clear Expectations: Use the briefing to provide participants with clear expectations about the simulation related to the purpose, objectives, and potential emotional challenges. Promote psychological safety through preparation of the participants for the possibility of increased stress, anxiety, or frustration during the simulation, and provide strategies to manage these emotions effectively.

Incorporate Emotional Intelligence: Emphasize the importance of emotional intelligence in healthcare practice and integrate opportunities to practice into the simulation scenarios. Encourage participants to recognize and regulate their emotions, as well as understand the emotions of others, to improve their clinical reasoning and decision-making skills.

Scaffold the Experiences: Gradually increase the complexity and difficulty of simulation scenarios to challenge participants’ cognitive skills and foster deep learning. Start with simpler scenarios and gradually progress to more complex and dynamic situations, allowing participants to build their cognitive abilities progressively.

Provide Feedback and Guidance: Offer timely and constructive feedback to highlight both the things that were done well and areas for improvement. Use feedback as an opportunity to facilitate self-reflection and self-assessment about the performance as well as the emotional response to the experience.

Use Debriefing for Emotion Processing: Debriefing is a crucial component of healthcare simulation that can be used to help participants process their emotional responses and link the responses to the learning objectives. Use debriefing techniques to encourage participants to analyze their emotional experiences and connect them with the cognitive aspects of the simulation.

Encourage Self-Reflection: Encourage participants to engage in self-reflection after the simulation to further process their emotional responses and reinforce their cognitive learning. This can be done through self-assessment, journaling, or guided reflection exercises. Self-reflection allows participants to gain insight into their emotions, thoughts, and behaviors during the simulation, and can facilitate deeper cognitive processing.

Practice Mindfulness: Incorporate mindfulness techniques into the simulation to help participants manage their emotions and improve their cognitive function. Mindfulness involves being present in the moment, without judgment, and can help participants regulate their emotions, reduce stress, and enhance their cognitive abilities, such as attention and focus.

Foster Peer Support: Encourage peer support and collaboration during the simulation to foster psychological safety and provide opportunities for participants to share their emotional experiences. Peer support can help participants normalize their emotions, validate their feelings, and offer different perspectives, which can aid in the processing and integration of cognitive and emotional aspects of the simulation.

Provide Resources for Emotional Support: Offer resources for emotional support, such as counseling services or access to mental health professionals, for participants who may require additional assistance in managing their emotions. Acknowledge that emotions are a natural part of the simulation experience and provide avenues for participants to seek support if needed.

Deep cognitive learning in healthcare simulation supports the acquisition of psychomotor and critical thinking skills by engaging higher-order cognitive processes. Emotions play a significant role in the learning process, and management of participants’ emotions is crucial to facilitate meaningful learning connections. Healthcare Simulation facilitators can effectively manage participants’ emotions and optimize the deep cognitive learning experience through the use of these techniques. When participants are able to process their emotional responses and connect them with the cognitive aspects of the simulation, they are more likely to engage higher order cognitive processes leading to a deeper learning experience.

Learn More About Cognitive Learning and Emotions

Janeen Berndt Avatar
DNP, CNS, BSN
Dr. Janeen Berndt is the National Director of Clinical Innovation and Integration at Galen College of Nursing. An expert in online nursing education, competency-based learning, and patient simulation, Janeen is a Certified Nurse Educator and Certified Healthcare Simulation Educator. She has incorporated all simulation modalities across pre- and post-licensure nursing curricula in a variety of teaching environments. Dr. Berndt uses her COVID19 experiences of leading the transition to alternate clinical experiences to expand the continued use of virtual learning to augment competency-based learning in prelicensure nursing. Additionally, her work in high-fidelity simulation has improved clinical experiences in rural nursing programs that face significant clinical site challenges. Janeen continues to advance simulation in the nursing profession serving as the OADN Simulation Committee Chair and as a member of the INACSL Patient Safety SIG. Dr. Berndt earned an ADN and BSN from Bethel University in Indiana as well as an MSN and DNP from Valparaiso University. She is active in Sigma, OADN, and INACSL and maintains membership in the NLN and ANCC. An expert clinician, she is board certified as an Adult Health Clinical Nurse Specialist specializing in geriatric-psychiatry and palliative care.