Debriefing for Meaningful Learning©: A Reflective Strategy to Foster Clinical Reasoning

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Clinical Simulation in Nursing

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There is a critical need for faculty, a shortage of clinical sites, and an emphasis on quality and safety initiatives that drive increasing use of simulation in nursing education. Debriefing is an essential component of simulation, yet nursing faculty are not consistently prepared to facilitate it, such that meaningful learning, demonstrated through clinical reasoning, occurs from the experience. The purpose of this presentation is to describe an exploratory, quasi-experimental, pre-test-post-test study that was undertaken to discover the effect of using a simulation teaching strategy, Debriefing for Meaningful Learning© (DML), on the development of clinical reasoning in nursing students.

Clinical reasoning was measured in 238 participant students from a Midwestern university school of nursing taking an adult health course that incorporates simulation experiences. Participants were assigned to either the experimental or control group where the DML was compared to customary debriefing using the Health Sciences Reasoning Test (HSRT) before and after the debriefing experience, and the Debriefing Assessment for Simulation in Healthcare©–Student Version (DASH©–SV) with four supplemental questions about the DML (DMLSQ) process, during the post-debriefing assessment.

This research sought to understand if the DML debriefing strategy positively influenced the development of clinical reasoning skills in undergraduate nursing students, as compared to usual and customary debriefing. The data revealed that there was indeed a statistical difference in scores measured by the HSRT. There was also a difference in the student's perception of the quality of the debriefing measured by the DASH©–SV. This study contributes to the growing body of knowledge about simulation pedagogy, provides tools for use in debriefing, and informs faculty on best practices in debriefing. It extends prior work defining debriefing and demonstrates the relationship between reflective learning and clinical reasoning through actionable decision-making in nursing.

Participants in this session will have an opportunity to experience the use of the DML strategy though role-play using components of the faculty guide and the student worksheets.


Clinical Simulation in Nursing, Vol. 7, No. 6 (November 2011). DOI.