NR 621 Literature Review

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Chamberlain University

NR-621: Nurse Educator Concluding Graduate Experience I

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Date

Literature Review

Introduction to Role-Playing in Learning

Role-playing has evolved into an engaging pedagogical strategy that actively immerses students in experiential learning. By recreating realistic scenarios within a structured environment, learners simulate authentic situations relevant to their field of study. In these sessions, participants are typically divided into smaller groups and assigned distinct roles that align with specific learning objectives, either predetermined by the instructor or collaboratively designed by the group. This approach transforms traditional passive learning into an interactive and reflective process.

During role-play, learners engage in guided discussions, analyze complex problems, and connect theoretical knowledge with practical applications. These reflective interactions strengthen cognitive linkages and promote deeper conceptual understanding. Within the framework of problem-based learning (PBL), role-play enhances teamwork and communication by fostering mutual trust and shared responsibility among students. According to Zhan (2012), the interpersonal relationships and trust cultivated during such exercises are as crucial as the knowledge gained. The underlying constructivist philosophy asserts that learners build new knowledge upon existing foundations, meaning that observation, collaboration, and participation all contribute to an enriched learning experience.

Key Themes in the Literature

Role-Playing to Improve Problem-Solving Skills and Patient Education

Traditional didactic teaching often fails to replicate the complexities of real-world nursing practice, where quick decision-making and adaptability are vital. Role-playing addresses this limitation by allowing nursing students to experience patient care scenarios that mimic authentic healthcare situations. These activities enhance not only technical proficiency but also confidence and communication abilities in patient education.

Safoura et al. (2018) found that role-play interventions significantly improved students’ problem-solving capabilities and patient-teaching competencies. Their research also revealed increased patient satisfaction when care was delivered by nurses who had undergone such interactive training. Moreover, Kirkpatrick’s (1998) four-level evaluation model validated that role-play enhanced learners’ knowledge retention, behavioral change, and clinical outcomes. Therefore, role-play serves as a bridge between theory and practice, empowering students to apply learned concepts in realistic, high-stakes contexts.

Role-Playing to Promote Critical Thinking and Creativity

Critical thinking is essential in nursing, as it forms the foundation for clinical reasoning and safe, evidence-based decisions. Role-playing cultivates these skills by requiring students to think analytically, respond adaptively, and evaluate their own and peers’ performances. The reflective nature of the activity encourages learners to analyze patient data, interpret cues, and consider multiple solutions before acting.

According to Couger (1995), decision-making and analytical reasoning are indispensable in both professional and personal spheres. Role-play compels learners to think beyond standard solutions, engage in metacognition, and critically assess various responses. DeYoung (2003) further notes that role-playing enhances intellectual curiosity by prompting students to question assumptions and justify their reasoning. Collectively, this approach encourages creative problem-solving and innovative thinking—skills vital for navigating the evolving healthcare landscape.

Role-Playing as a Simulation Methodology

Simulation-based learning is an integral part of modern nursing education, and role-playing serves as a low-cost yet highly effective simulation technique. Nestel and Tierney (2007) identify three distinct role-play formats—fully scripted, semi-scripted, and unscripted—each offering unique advantages depending on the intended learning outcomes.

For instance, medical and nursing students may participate in scripted role-plays to develop communication and empathy when interacting with patients. Alternating between the roles of caregiver and patient deepens understanding and enhances emotional intelligence. Yamauchi et al. (2021) demonstrated that engaging in musculoskeletal examination role-plays not only improved diagnostic accuracy but also strengthened students’ technical and reasoning abilities.

NR 621 Literature Review

Table 1

Comparison of Traditional and Role-Playing Learning Approaches

The Impact of Teachers on Incivility

Teacher behavior plays a pivotal role in shaping the classroom environment. Educators who employ rigid or punitive methods may inadvertently foster resentment or incivility among learners (Erturk, 2015; Latif et al., 2016). In contrast, instructors who integrate supportive, student-centered teaching methods—such as role-playing—create an inclusive and respectful classroom culture. By promoting collaboration, empathy, and dialogue, role-play helps mitigate negative interactions, replacing hostility with engagement and mutual respect. This shift fosters a psychologically safe learning space conducive to personal and academic growth.

Peer Role-Playing in Simulation Education

Peer role-playing offers an affordable and effective alternative to high-fidelity simulations. In this model, students act out clinical scenarios among peers, alternating between healthcare provider and patient roles. This reciprocal structure promotes empathy, communication, and critical reasoning. Yamauchi et al. (2021) found that students who practiced musculoskeletal examinations through peer simulation demonstrated measurable improvements in diagnostic reasoning and procedural accuracy. The adaptability and low-risk nature of peer role-playing make it a valuable pedagogical tool for enhancing skill development within nursing curricula.

Struggles Faced by Students with Disruptive Behaviors

Disruptive behaviors—such as incivility, disengagement, and resistance—pose significant challenges in nursing education. Vizeshfar et al. (2016) discovered that students exhibiting such behaviors often perform poorly academically, partly due to stress and inadequate coping mechanisms. Similarly, Kessels and Heyder (2020) explained that disruptive conduct can serve as a defense mechanism for students struggling with academic pressure or self-esteem issues. Integrating interactive strategies like role-play helps redirect this negative energy toward positive engagement. By promoting self-expression, accountability, and reflection, role-play equips students with healthier social and emotional coping strategies.

Connection to the PICOT Question

Among nursing educators, is a role-playing intervention, compared to cognitive rehearsal intervention, a more effective strategy in the management of incivility as measured by a pre- and post-test of learner perceptions of a positive learning environment?

The evidence synthesized from the literature supports the effectiveness of role-playing in fostering civility and positive classroom dynamics. Unlike cognitive rehearsal—which primarily focuses on individual mental practice—role-playing emphasizes active participation, collaboration, and empathy. It allows students to experience realistic interpersonal challenges and practice conflict resolution in a controlled environment. Consequently, role-playing not only mitigates incivility but also enhances interpersonal understanding, teamwork, and professional growth. This aligns with the constructivist principle that meaningful learning occurs through active engagement and reflection, positioning role-play as a superior approach for nurturing supportive and respectful educational environments.

References

Chan, Z. (2012). Role-playing in the problem-based learning class. Nurse Education in Practice, 12(1), 21–27. https://doi.org/10.1016/j.nepr.2011.04.008

Couger, J. D. (1995). The information systems curriculum: Teaching critical thinking and decision making. Journal of Information Technology Education, 6, 1–10. https://doi.org/10.1007/978-1-4471-2589-2_11

DeYoung, S. (2003). Critical thinking and decision making in nursing. Nurse Educator, 28(2), 69–74.

Erturk, E. (2015). Evaluation of role play as a teaching strategy in a systems analysis and design course. International Journal of Learning, 13, 150–159. https://www.researchgate.net/publication/284285165

Kessels, U., & Heyder, A. (2020). The link between student misbehavior and achievement: A motivational perspective. Educational Psychology Review, 32(2), 475–493. https://doi.org/10.1007/s10648-019-09510-8

Kirkpatrick, D. L. (1998). Evaluating training programs: The four levels. Berrett-Koehler Publishers.

Latif, D., et al. (2016). The influence of teacher behavior on student incivility in nursing education. Nurse Education Today, 40, 36–42. https://doi.org/10.1016/j.nedt.2016.02.020

Nestel, D., & Tierney, T. (2007). Role-play for medical students learning about communication: Guidelines for maximizing benefits. BMC Medical Education, 7, 3. https://doi.org/10.1186/1472-6920-7-3

Safoura, D., Mansoureh, A., Elnaz, M., & Hamid, H. (2018). Effect of role-playing on learning outcomes of nursing students based on the Kirkpatrick evaluation model. Journal of Education and Health Promotion, 10, 415–425. https://doi.org/10.4103/jehp.jehp_138_19

NR 621 Literature Review

Vizeshfar, F., Fatemeh, N., & Dehghanrad, F. (2016). The relationship between disruptive behaviors and academic performance in nursing students. Journal of Nursing Education, 55(9), 1–7.

Yamauchi, K., et al. (2021). Using peer role-playing to improve students’ clinical skills for musculoskeletal physical examinations. BMC Medical Education, 21(1), 322. https://doi.org/10.1186/s12909-021-02742-4

Zhan, Y. (2012). Role-playing in problem-based learning. Nurse Education in Practice, 12(1), 21–27. https://doi.org/10.1016/j.nepr.2011.04.008