Abstract:

Simulation-based learning has become a central component of nursing education and is institutionalized in dedicated skills and simulation labs. Empirical research demonstrates its effectiveness particularly at the first two levels of the Kirkpatrick model: high satisfaction, increased self-efficacy, and improved skills within the setting. The evidence becomes thinner at the levels of behavioural and patient outcomes, where the question of transfer from the lab to the bedside remains largely unanswered. This empirical gap is accompanied by a conceptual one: as Dumstorff (2024) notes, no specific learning-theoretical approach yet explains why simulation-based learning works and under what conditions it becomes effective. This study brings together three perspectives typically treated separately in simulation research: a sociological perspective (framing), a learning-theoretical perspective (schema revision and experience), and a neuroscientific perspective (predictive processing). Across these approaches, learning emerges as the processing of a discrepancy between expectation and experience within a situated, embodied, and social process. On this basis, the concept of difference experience is proposed as the unifying principle of simulation-based learning and differentiated into three types: cognitive, biographical, and collective. Combined with the established three-phase simulation structure (briefing, scenario, debriefing), this yields a 3×3 heuristic that can be used both analytically and in didactic planning.

Keywords:

Hybrid Simulation, Mixed Reality (MR), AI-enabled adaptive interaction partners, Didactic orchestration.