An activity theory perspective of how scenario-based simulations support learning: a descriptive analysis.

The findings suggest that student participants learned as they engaged in these scenario-based simulations when they worked to make sense of the patient's clinical presentation. The findings may provide insight into how student participants' meaning-making efforts are mediated by the cultural artifacts (e.g., physical clinical tools) they access, the social interactions they engage in, the structured interventions they perform, and the roles they are assigned. The findings also highlight the complex and emergent properties of scenario-based simulations as well as how activities are nested. Implications for learning, instructional design, and assessment are discussed.