Background: High-fidelity simulation (HFS) is a cognitive load inducing educational tool that gives participants an opportunity to emulate clinical scenarios by assuming various roles. HFS offers opportunities for undergraduate nursing students to build fundamental knowledge that can replace, or enhance, clinical experiences. Cognitive load exists on a spectrum and negatively impacts learning when learners are at either extreme of the spectrum. Cognitive load is comprised of the three subcomponents of intrinsic, extraneous, and germane load. Not much is known about different subcomponents or their ability to prediction immediate knowledge and knowledge retention in students who play fundamentally different roles, as active participant versus participant observer, during the simulation. Purpose: The purpose of this research was to investigate the relationship between cognitive load, in its whole and its parts, and learner role (active participant versus participant observer) on immediate knowledge and knowledge retention in undergraduate senior nursing students following a high-fidelity simulation. Methods: A non-experimental predictive correlational design was used with a cohort of senior Bachelor of Science in Nursing (BSN) students. The data included demographic information, an adapted Cognitive Load Inventory (Leppink et al., 2013), and initial and two-week knowledge retention tests developed by the author. Logistic regression models were used to analyze the data. Findings: There were no significant differences between cognitive load ratings, immediate learning outcomes, and retention learning outcomes between active participants and participant observers. Conclusion: Active participants and participant observers reported similar ratings of cognitive load and achieved similar learning outcomes following the high-fidelity simulation, regardless of role. The study results contribute to the body of literature supporting both active participant and participant observer roles as valuable learning opportunities in high-fidelity simulation.
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Doctor of Philosophy (Ph.D.)
College of Nursing
Length of Campus-only Access
Doctoral Dissertation (Campus-only Access)
Houston, Amanda, "The Relationship of Cognitive Load and Different Participant Roles on Knowledge Retention in Simulation-based Learning Among Undergraduate Nursing Students" (2020). Electronic Theses and Dissertations, 2020-. 610.