A Theoretical Framework for Simulation in Nursing: Answering Schiavenato’s Call

The aim of this article was to provide a response that supports and extends Schiavenato’s call for a theoretically guided approach to simulation use in nursing education. We propose that a theoretical framework for simulation in nursing must first include, as a basis, a theoretical understanding of human performance and how it is enhanced. This understanding will, in turn, allow theorists to provide a framework regarding the utility, application, and design of the training environment, including internal and external validity. The expert performance approach, a technique that recently has been termed Expert-Performance-based Training (ExPerT), is introduced as a guiding framework for addressing these training needs. We also describe how the theory of deliberate practice within the framework of ExPerT can be useful for developing effective training methods in health care domains and highlight examples of how deliberate practice has been successfully applied to the training of psychomotor and cognitive skills.