Debriefing in simulation conducted in small and large groups - nursing students’ experiences

Abstract

The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students' experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.

Survey of factors influencing learner engagement with simulation debriefing among nursing students

“…Confidentiality was a significant influencing factor for learner engagement with simulation debriefing. The fear of failure or disclosure in the presence of many unknown fellow students can hamper learning (Tosterud et al ., ). Educators should embrace a learner‐centered approach to facilitation (Cheng et al ., ; McMullen, Wilson, Fleming, et al ., ).…”

“…Smaller groups containing fewer than six students per group are preferred over larger groups (Adamson, ; Partin, Payne, & Slemmons, ). Irrespective of group size, nursing students fear embarrassment or failure in front of fellow students (Tosterud, Hall‐Lord, Petzäll, & Hedelin, ). The optimal size for a debriefing group remains unclear.…”

Simulation debriefing for clinical judgment development: A concept analysis

“…The second consequence is improving students' psychomotor skills performance (Levett-Jones and Lapkin, 2014), which has been linked to confidence, important to student development as a nurse (Bambini et al, 2009) and clinical judgment ability (Lasater, 2007a). The third consequence is students' ability to transfer simulation learning to clinical practical settings or bridge the theory-practice gap (Gum et al, 2011;Lasater et al, 2014;Tosterud et al, 2014). However, the occurrence of these consequences is dependent on guiding students' active participation during debriefing, assisting them to connect their knowledge to their actions through reflection.…”

“…The degree to which the debriefing session is structured can be measured by exploring students' (Cantrell, 2008, Tosterud et al, 2014 and faculty perceptions (Mariani et al, 2014) of the effectiveness of debriefing sessions using qualitative descriptive design. Another way to ensure a structured debriefing session is to utilize a model case of debriefing, such as the one to follow.…”

“…There is increasing evidence that simulation debriefing can improve nursing students' clinical judgment (Dreifuerst, 2012;Forneris et al, 2015;Mariani et al, 2014;Tosterud et al, 2014). However, the literature reveals a lack of standardized methodological approaches for debriefing practice (Couper and Perkins, 2013;Lavoie et al, 2013) and unclear descriptions of debriefing (Waznonis, 2014).…”