Medicine and Health Sciences Commons^™

Contextualizing Learning In A Resuscitation Simulation Experience: A Supportive Approach To Simulation For Novice Learners, Robert Catena, Heather Maclean

Quality Advancement in Nursing Education - Avancées en formation infirmière

Introduction: Simulation based experiences (SBEs) continue to be utilized in undergraduate nursing programs as a teaching strategy to contextualize learning. This is especially important for novice students in a resuscitation SBE, where it is important to learn not only psychomotor skills but also the skills required for teamwork, understanding roles, and communication in teams, inherent to nursing practice.

Background: Undergraduate nursing students desire teaching strategies to support their learning during high impact SBEs, such as cardiopulmonary resuscitation. These strategies need to support novice learners by providing timely feedback on performance, uncover immediate knowledge gaps, and offer opportunities for deliberate practice. …

How We Debrief: An Interpretive Description Of Social Service Community Workers' Experiences, Andrea C. Krywucky

Electronic Thesis and Dissertation Repository

The aim of this research was to understand current practices of debriefing being used or not used in community social service organizations and the presumed frameworks or evidence justifying these practices in London, Ontario. The geographical area under concern has seen an increasing poverty gap, lack of affordable housing, toxic drug crisis, with mental health issues being exasperated by the pandemic. Social service agencies are overwhelmed with caseloads, creating an increase in need of care for frontline workers, as they are the first point of contact for many. This research utilized an interpretive description methodology to explore workers’ experiences and …

Improving Student Nurse Clinical Reasoning, Critical Thinking, And Clinical Judgment Through Simulation Debriefing, Deborah Brester

Walden Dissertations and Doctoral Studies

Simulation is an educational strategy in nursing education that incorporates structured activities that depict real-life situations to develop and enhance the knowledge, skills, and attitudes of nursing students by allowing them to analyze and initiate interventions for realistic situations in a simulated environment. Debriefing is a reflective process and is a key component in the simulation education process, but there is a lack of evidence on debriefing methods that enhance learning outcomes in nursing education. This study, which was guided by the National League for Nursing Jeffries simulation theory, was to determine the effect simulation debriefing, as assessed using the …

Implementation Of A Critical Event Debriefing Tool In The Pediatric Intensive Care Unit, Tara Fiala

Dissertations

Problem: Working in the Pediatric Intensive Care Unit (PICU), staff encounter critical patient events without warning. Debriefing after adverse patient events has been shown to give staff the opportunity to process these events in an open, honest, and judgement-free environment. Debriefing has been recognized as a tool for detecting medical errors, improving team communication, providing emotional support, and analyzing team performance.

Methods: A descriptive, observational pilot study was used to implement the DISCERN tool into a large, midwestern, urban PICU. The aim of the quality improvement project was to achieve a debriefing tool completion rate of 20% over a one-month …

Acquiring, Applying And Retaining Knowledge Through Debriefing For Meaningful Learning, Anne Loomis, Kristina Dreifuerst, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Abstract

Acquiring, Retaining and Applying Knowledge Through Use of Debriefing for Meaningful Learning (DML).

Background

Developing competence in nursing care is a critical expectation of nursing students. Knowledge acquisition, application and retention are the primary building blocks of competence. DML debriefing offers an opportunity to ensure that students master critical components of nursing they might not otherwise learn and to remove epistemological roadblocks to knowledge development.

Methods

Eighty-two traditional prelicensure baccalaureate nursing students from a single school participated in the study. This quasi-experimental pretest, posttest study explored the impact of the use of Debriefing for Meaningful Learning compared with customary …

Cross-Cultural Validation And Psychometric Testing Of The Debriefing Experience Scale (Des): A Cross-Sectional Study, Ya Dian Xie, Xin Yi Li, Qian Liu, Run Huang, Ting Li, Ya Xuan Fang, Dan Luo, Yonghui Wan, Bing Xiang Yang, Shelly J. Reed

Faculty Publications

Background

The Debriefing Experience Scale (DES) is a tool that is used to explore nursing students’ subjective experiences during a debriefing and to help determine best debriefing practices. A Chinese version of the scale has not been found; its development can enhance learning in simulation activites in Chinese healthcare education programs.

Methods

A simplified Chinese version of the DES was developed and tested using 34 Chinese undergraduate (second year) nursing students. They participated in six simulation scenarios and debriefings. Eight experts were consulted to determine the content validity of the scale. Critical ratio method, Cronbach’s alpha, intraclass correlation coefficient, correlation …

Postpartum Hemorrhage: Improving Patient Outcomes With Improved Communication And Post-Drill Debriefing, Sheila L. Lafortune

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: A woman is at risk of dying from postpartum hemorrhage every four minutes. Maternal hemorrhage is found to be the direct cause of maternal mortality, overall accounting for 27% to 75% of maternal deaths worldwide. In the United States, 54% to 93% of maternal mortality could have been prevented. Postpartum hemorrhage remains among the top causes of pregnancy-related deaths worldwide. The purpose of this project is to educate providers of obstetrical care regarding best practices for effective communication during a postpartum hemorrhage by implementing a debriefing educational tool during postpartum hemorrhage mock code drills. Methods: The postpartum …

Debriefing With Pearls & Watson’S Caritas, Heather A. Uccello

Seton Hall University Dissertations and Theses (ETDs)

Debriefing, an important aspect of students’ clinical experience, is a reflective, critical thinking analysis and communication strategy that provides rapid feedback after either a simulated or genuine clinical event. To teach this higher-level critical thinking skill throughout the learning process, nursing programs require specific methodology and faculty expertise. The National League for Nursing supports nurse educators having a theory-based strategy, formal training, and ongoing competency evaluation. Informed by Jean Watson’s Theory and the Promoting Excellence and Reflective Learning in Simulation standardized debriefing tool methodology, this project outlines a framework that nursing schools can use to potentially improve the debriefing process …

Evaluation Of High Fidelity Simulation Debriefing Methods For Nurse Anesthesia Students, Zachary Standefer, Alex Davie

Doctor of Nursing Practice Projects

Simulation for Student Registered Nurse Anesthetists has become an educational tool that provides valuable learning experiences that integrate problem-solving, prioritization, and critical thinking skills. Debriefing is an essential aspect of the simulation learning process. The debriefing period allows the debriefer to direct the students’ self-reflection and provide individualized feedback. Faculty members delivering the simulation curriculum at a midwestern university, with over 75 nurse anesthesia students, sought education regarding the various simulation debriefing methods. After conducting a literature review for the best evidence supporting debriefing methods, faculty education was implemented in the form of an interactive computer-based learning (CBL) module. The …

Leadership Strategies To Support Resilience, Katee Paine

Nursing Masters Papers

Healthcare institutions have garnered national attention due to high levels of healthcare worker burnout, stress, and turnover rates. As the largest population of healthcare workers, nurses are often confronted with stressors that can lead to burnout in their practice and work environment. The global COVID-19 pandemic has highlighted and magnified these stressors over the past year, such as emotional strain of caring for dying patients, long shifts, rotating schedules, increased workload demands, and high-stress work environments. Resilience, characterized by an ability to bounce back from adverse situations, has been found to play an important role in navigating and adapting to …

Debriefing: A Place For Enthusiastic Teaching And Learning At A Distance, Cynthia Sherraden Bradley, Brandon Kyle Johnson, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

The current pandemic has required a quick response to the unprecedented suspension of face-to-face instruction in higher education worldwide. The rapid conversion of didactic, laboratory, and clinical courses to distance learning has been challenging, requiring integration of screen-based virtual simulations and other innovative learning activities. The importance of a robust debriefing of these learning opportunities is often neglected, which could be to the detriment of the students. Debriefing is based on strong narrative pedagogy, requiring an engaging and enthusiastic dialog. Despite long days of screen time, it is even more imperative to connect with students to create meaningful learning through …

Measuring Learning And Engagement During Debriefing: A New Instrument, Shelly Jensen Reed

Faculty Publications

Background: Debriefing is considered to be where the bulk of learning takes place. Examination of debriefing is needed to help determine if facilitation methods effectively contribute to the learning process. More instruments are needed to evaluate all key debriefing elements, and no tools exist that evaluate participant engagement in the learning process.

Method: Kolb’s experiential learning theory was used to inform tool development. The focus of the new instrument is behaviors that indicate engagement with the learning process as the learner moves through Kolb’s learning cycle. A qualitative study of debriefing facilitators was performed, and a behaviorally anchored instrument was …

Critical Incident Stress Debriefing For Nurses In Emergency And Critical Care Departments, Rachel A. Davis

MSN Capstone Projects

Front-line healthcare workers such as emergency department nurses, trauma nurses, and other nurses working within intensive care services are exposed to significant trauma on the job as they care for their critically wounded and dying patients. While trauma cannot be removed from the job descriptions of such staff members, individuals and their facilities can work together to try and ensure traumatic events do not have significant, lasting effects on the mental well-being of these nurses. Critical incident stress debriefing (CISD) after traumatic events in the workplace has been cited as a relatively inexpensive way to decrease the impact of negative …

Simulation In Nursing Education: A Literature Review On Debriefing, Rebecca Rausch

Nursing Masters Papers

The purpose of this literature review is to evaluate and compare debriefing models used during simulation experiences and to make recommendations for nurse educators and researchers about debriefing. Learning does not occur during a simulated experience alone, but occurs as a result of the experience and the purposeful reflection and analysis following the experience. This purposeful guided reflection and analysis is known as debriefing. The method used in this scholarly inquiry paper is a literature review.

Five debriefing frameworks were reviewed and summarized in detail. The goal was to identify best practices for simulation debriefing to foster undergraduate nursing students’ …

Relationship Between Post-Resuscitation Debriefings And Perceptions Of Teamwork In Emergency Department Nurses, Kerri Lyman

Walden Dissertations and Doctoral Studies

Emergency department nurses are faced with traumatic patient events while functioning as members of multidisciplinary teams. Critical incident debriefing has been shown to benefit health care professionals and patient clinical outcomes. The purpose of this quantitative correlational study was to examine the relationship between the use of formal post-resuscitation debriefings and perceptions of teamwork in emergency department nurses. The study also addressed the type and timing of debriefing to determine whether these factors impacted perceptions of teamwork. The nurse as wounded healer theory served as the theoretical framework. Data from the Nursing Teamwork Survey were collected from 68 emergency department …

Failure-To-Rescue Simulations As A Risk Management Strategy For Registered Nurses, Trena K. Seago

Graduate Theses, Dissertations, and Capstones

In the hospital setting, prevention of failure-to-rescue (FTR) events is an important aspect of patient safety. The use of patient simulation as a strategy to educate nurses on the prevention of these events offers two modes of learning: 1) experiential learning through simulation and 2) reflection through debriefing. The act of practicing to recognize a deteriorating patient through experiential learning and reflection may help increase nurses’ self-efficacy in recognizing a similar situation in their future practice. This quasi-experimental, one-group, pretest-posttest pilot study investigated the use of patient simulation among registered nurses (RNs) in the hospital setting as an anticipatory educational …

Implementation Of A Scripted Debriefing Tool In Simulation-Based Nursing, Mary Kidd

DNP Scholarly Projects

In nursing education, simulation represents real patient scenarios that are designed to enable students to practice combining theoretical knowledge with clinical skills within a controlled environment (Bland, Topping, & Wood, 2011). Debriefing is a facilitated reflection of the simulation experience and is performed to uncover relationships among the events, actions, thought processes and outcomes with the intention of improving future practice (Cheng et al., 2014; Kolbe, Grande, & Spahn, 2015). Without proper debriefing, erroneous critical thinking, decision-making, and clinical judgement may go uncorrected, potentially negatively impacting patient care. There is an abundance of literature on debriefing methods; yet, empirical evidence …

Try To See It My Way: Patient Perspective Video Capture Debriefing In Simulation, Terri Hendry

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Video capture of simulation provides observation from a wide-angle view. This study introduced a new technique, “patient-perspective” video capture, using a camera mounted into eyeglasses allowing learners to view their nonverbal and verbal communication through the patient’s eyes and to compare this to the wide-angle view. The participants (n = 29) were Nurse Practitioner students. The majority were female (93.2%), with a mean age of 36.8, SD = 12.31. The sample consisted of Millennials (65.6%), Generation Xers (13.8%), and Baby Boomers (20.7%). The average number of years of nursing practice was 9.89. Instruments measured demographics, five domains of patient-centered care …

The Effect Of The Behavioral Analysis Feedback Model On Improving Performance Of Nursing Students During Clinical Rotations, Melanie Elizabeth Ross

STEMPS Theses & Dissertations

This study explored the effects the Behavioral Analysis Feedback (BAF) Model had on improving nursing student’s performance. Research studies surrounding feedback primarily centered on frameworks designed as models for delivering feedback as well as the timing for delivering feedback. In addition, past research has also focused on individual elements that affect performance with little regard to environmental elements. The BAF Model was conceptualized based on the importance of providing feedback to nursing students while emphasizing three individual and three environmental elements that have the potential to influence behavior.

This multiple measure, single-case study utilized a quasi-experimental pre-post intervention study design. …

Debriefing With Reflection: Best Practice For Learning In Simulation In Pre-Licensure Nursing Education, Mary Mcdermott

Seton Hall University DNP Final Projects

Purpose: The purpose of this project was intended to transform the outdated method of conducting debrief after simulation by implementing a good judgment model and integrating the concept of “advocacy-inquiry.” This implementation was expected to reduce demoralizing and anxiety producing debrief experiences and improve student reflection and learning in order for students to more deliberately link theory with practice.

Significance: The debrief is often recognized as the component of simulation in which the most effective learning occurs. It is the time when students are provided opportunity to reflect on thoughts, actions and behaviors. Unfortunately, many nursing students often experience undue …

Evaluation Of A Pilot Multidisciplinary Debriefing Program: Promoting Pediatric Provider Emotional, Social, And Spiritual Wellbeing, Allison E. Reynolds

Doctoral Projects

Regular exposure to trauma, such as the act of bearing witness to intense suffering and pain of pediatric patients and families, has a significant effect on healthcare professionals. Despite the fact that traumatic situations in pediatrics are a reality, there is little education and few interventions focused on how to prepare and support healthcare providers to care for dying children and families or for other clinically challenging situations. Pediatric residency program directors within a large, freestanding children’s hospital identified a subjective need for support for their pediatric residents in dealing with clinically challenging situations faced during residency, motivating residency program …

Bsn Students’ Satisfaction And Self-Confidence In Simulation-Based Learning, Aubrey Winum

Undergraduate Honors Theses

As nurse educators prepare students to enter the real world, they are challenged to create learning methods that develop confident and competent nurses. While new graduate nurses have much to learn, they are expected to be able to work as a team, think critically, and provide a safe environment for patients. A nursing program at a small, liberal arts college in the Foothills of the Blue Ridge Mountains utilized simulation-based learning experiences to prepare students for the many situations they may face as a future nurse. The purpose of this study was to evaluate the impact these experiences had on …

A Quality Improvement Project: Adopting The Standards Of Best Practice In Simulation: Debriefing With Pearls, Rebecca Lea Hooper Keesee

Doctor of Nursing Practice Projects

Background

There is evidence the best practices of simulation, specifically, the use of debriefing, will assist the new graduate nurse’s transition into the profession by increasing their clinical judgment. This quality improvement (QI) project explored the pedagogy of High Fidelity Simulation and Debriefing as a solution for the lag in New Graduate Nurse (NGN) practice readiness. The specific aims of this project were: 1) to teach the NGN residency educators how to implement Standard: Debriefing of the International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practices: Simulation^SM by focusing on the role of the debriefer; …

Debriefing In The Emergency Department, Alyssa Johnson

Master's Projects and Capstones

Emergency Department (ED) staff are repeatedly exposed to high stress situations and as a result suffer from compassion fatigue, secondary traumatic stress, symptoms of post-traumatic stress disorder, burnout and high turnover rates. Staff turnover is costly to the health system in the form of training new staff and potential poor patient outcomes due to under staffing or inexperience of staff. Based on a survey about debriefing, Level 1 Adult and Pediatric Emergency Department staff reported 81% felt there was inadequate support for critically stressful events that occur. Debriefing was identified by 75% of the staff as an option for support. …

Pilot Testing The Debriefing For Meaningful Learning Evaluation Scale, Cynthia Sherraden Bradley, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Background

Debriefing for Meaningful Learning (DML), an evidence-based debriefing method, promotes thinking like a nurse through reflective learning. Despite widespread adoption of DML, little is known about how well it is implemented. To assess the effectiveness of DML implementation, an evaluative rubric was developed and tested.

Sample

Three debriefers who had been trained to use DML at least 1 year previously, submitted five recorded debriefings each for evaluation.

Methods

Three raters who were experts in DML scored each of the 15 recorded debriefing session using DML Evaluation Scale (DMLES). Observable behaviors were scored with binary options. These raters also assessed …

Identifying Learning Acquired During Debriefing, Shelly J. Reed

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing, the reflective activity following an experiential learning exercise, has been identified as the most important part of simulation learning and is also important for learning in other activities utilized in nursing education. There is general agreement that debriefing provides learning and improves performance. However, there is little specific evidence about the phenomenon of learning acquired during debriefing, including how it occurs, how it is defined and identified, and how it is evaluated by debriefing facilitators. In addition, there are no instruments or tools specifically measuring learning acquired during debriefing. Without practical and theoretically grounded tools, simulation activities will continue …

Use Of A Blog In An Undergraduate Nursing Leadership Course, Shelly Jensen Reed, Debra Edmunds

Faculty Publications

In this study, the use of a blog in a senior leadership clinical nursing course was analyzed qualitatively through two means; focus group interviews of those using the blog, and analysis of blog content. Initial feelings expressed by students were annoyance and intimidation concerning the blogging assignment. These feelings quickly dissipated, with students verbalizing many positive aspects related to the blog, including having a place to reflect, feeling connected as a group, valuing feedback provided by their peers, and learning from theirs and others' experiences. The mechanics of having to synthesize their thoughts in written form, in a shared venue …

Written Debriefing: Evaluating The Impact Of The Addition Of A Written Component When Debriefing Simulations, Shelly Jensen Reed

Faculty Publications

Debriefing, the reflective period following a simulation, is said to be where the bulk of simulation learning takes place. Many expert opinions regarding debriefing exist, but evidence-based best practices have yet to be identified. Written debriefing is one of these practices; experts state learning can be extended through the addition of a written component to the debriefing process, but no evidence exists to support this. This study compares three debriefing types: discussion alone, and discussion followed by journaling or blogging. Undergraduate nursing students participating in a simulation were randomized as a simulation group to one of these three debriefing types. …

A Systematic Review And Development Of Best Practice In The Usage Of Video Recording During Debriefing Of Simulation With Undergraduate Nursing Students, Sarah J. Rodewald, Andrea M. Bell

Master of Science in Nursing Evidence-Based Practice Projects

The purpose of this evidence based project was to evaluate current literature and synthesize the best practice guidelines for debriefing and video-assisted debriefing (VAD) as it relates to simulation-based learning for undergraduate nursing students. Presently, high fidelity patient simulators (HFPS) and various debriefing techniques are used in many different occupational fields. Facilitator led verbal debriefing is a standard practice in nursing schools following a simulation to guide student reflection and learning. Newer technology, however, is now allowing for video-recording and annotation of simulations for enhanced debriefing sessions and can be used for immediate review. Some evidence-based guidelines exist for standard …

Getting Started With Debriefing For Meaningful Learning, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning© (DML) is a method of debriefing that can be used in simulation environments and other clinical settings to foster student's reflective thinking and learning. It has been used successfully with prelicensure nursing students, graduate nursing students, and interdisciplinary health care students throughout the nursing curriculum with positive learning outcomes. This method can be challenging to learn because it uses Socratic questioning and principles of active learning to uncover thinking associated with actions, but once learned, DML can be a model for reflective thinking that students can use to develop clinical reasoning and become reflective practitioners. Moreover, …