Post-Simulation Structured Debriefing on Clinical Reasoning Skills Among Associate Degree Nursing Students: A Randomized Controlled Trial
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Background: Debriefing is considered the most important aspect of simulation. As nursing programs utilize simulation as a substitution for traditional clinical experiences, it is necessary to compare different types of debriefing and their impact to student learning. The purpose of this randomized-controlled trial was to compare the effects of a structured debriefing method, Debriefing for Meaningful Learning©, (DML), and an unstructured debriefing method following a simulation activity on clinical reasoning skills among associate degree nursing students. Methods: Participants from one Midwest associate degree nursing program were randomized to the intervention group or the attention-control group following a simulation activity. The intervention group received the DML method and the attention-control group received an unstructured debriefing. Demographics and the Nurses Clinical Reasoning Scale pretest and post-test were collected and analyzed. Results: In this study, 67 associate degree nursing students participated with 33 in the intervention group and 34 in the attention-control group. The average age of participants was 28 and 61 participants were female. On average, participants who received the DML intervention scored 0.29076 higher on the clinical reasoning post-test than the participants who received the unstructured debriefing. This was statistically significant (p=.032) between the intervention group and the attention-control group on the pre-test and post-test clinical reasoning scores. Conclusion: The results suggest that using the DML structured debriefing following a simulation activity may increase the clinical reasoning skills of associate degree nursing students. Future studies are needed utilizing multiple research sites. It is recommended to utilize an instrument that is more objective in nature and that the debriefing facilitator be evaluated on the implementation of the intervention after receiving training and prior to data collection.
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Introduction -- Literature review -- Methods -- Results -- Appendix A. Letter of support - Labette Community College -- Appendix B. Institutional Review Board approval - UMKC -- Appendix C. Exempt research study information sheet -- Appendix D. Nurses Clinical Reasoning Scale- Permission email -- Appendix E. Debriefing for meaningful learning - permission letter -- Appendix F. Nurses Clinical Reasoning Scale - pretest -- Appendix G. Demographic information sheet -- Appendix H. Prebriefing simulation scenario -- Appendix I. Nurses Clinical Reasoning Scale - post-test
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Ph.D. (Doctor of Philosophy)