Debriefing Model for Psychological Safety in Nursing Simulations: A Qualitative Study

Abstract

This study was conducted to explore nursing students’ emotional experiences during simulations, and to develop a debriefing model for psychological safety in nursing simulations by qualitatively analyzing data. Data were collected through face-to-face in-depth interviews with 23 undergraduate nursing students in South Korea. Via content analysis, nine categories were derived: fear of evaluation, burden of being observed, unfamiliarity with new ways of learning, sensitivity to interpersonal relationships, physical and emotional exhaustion, utilization of supportive relationships, decline in learning satisfaction, positive acceptance of stress, and attempts to relieve stress. On the basis of these insights, we developed the Share–Explore–Notice–Support–Extend (SENSE) debriefing model, which includes stress management and emotional support, as a strategy for effective simulation practices to reduce the negative experiences of stress in nursing students in simulation-based learning.

A rollercoaster of emotions: An integrative review of emotions and its impact on health professional students' learning in simulation‐based education

“…Several studies highlighted the reasons for anxiety and stress associated with simulations (Beischel, 2013;Cato, 2013;Groot et al, 2020;Holt, 2017;Ko & Choi, 2020;Najjar et al, 2015;Tremblay et al, 2017;Walton et al, 2011). Fear of the unknown and being evaluated, uncertainty about treatment options and feeling unprepared for the simulation setting are important explanations.…”

“…Stress, embarrassment, confusion, enjoyment and pride are evident during the unfolding of the scenario. The various reported emotional outcomes after the end of the simulation range from fear, anxiety, shame, frustration, confidence, calm, nervousness, disappointment, surprise and worry, to enjoyment, excitement, happiness, pride and feeling challenged (Behrens et al, 2019;Fraser et al, 2012;Fraser & McLaughlin, 2018;Groot et al, 2020;Holt, 2017;Ko & Choi, 2020;Schlairet et al, 2015;Walton et al, 2011). Students also report feeling a "sigh of relief"…”

“…by letting the manikin die) achieved greater practical competence than those who were not exposed to this scenario. Several studies found that moderate anxiety is experienced by students as a driver of learning (Al-Ghareeb et al, 2019;Behrens et al, 2019;Groot et al, 2020;Ko & Choi, 2020). Five studies identified compound learning outcomes such as confidence and feeling more secure, despite the students being emotionally aroused.…”

“…Five studies identified compound learning outcomes such as confidence and feeling more secure, despite the students being emotionally aroused. Students have reported that they gain experience by practising clinical reasoning and critical thinking, and by learning to identify errors, and that the simulation experience seems to motivate them to improve and to direct their own learning (Groot et al, 2020;Holt, 2017;Ko & Choi, 2020;Najjar et al, 2015;Tremblay et al, 2017;Walton et al, 2011). For example, during a simulation, students learn to analyse the patient's situation and to prioritize and implement interventions (Walton et al, 2011).…”

Efeito da simulação de alta fidelidade na ansiedade do estudante de Enfermagem: ensaio clínico randomizado

“…Estudos apontam que a ansiedade provocada pelo EBS possui diversas causas, a saber: a expectativa pelo cenário; o fato de ser observado por colegas e/ou docentes; receio de que a confidencialidade não seja respeitada; falta de autoconfiança e competência; dificuldade nas relações interpessoais com o paciente; equipe multiprofissional e colegas; tempo reduzido da simulação; exaustão física e emocional; o fato de estar sendo avaliado; e o desconhecimento do método de EBS (Nielsen & Harder, 2013;Al-Ghareeb AZ, Cooper & Mckenna, 2017;Ko & Choi, 2020).…”