Self-debriefing in healthcare simulation: An integrative literature review

Virtual Reality Simulation Integration in a Prelicensure Nursing Program: Lessons Learned

BACKGROUND

Simulation, whether conducted live or through virtual technologies, provides students with experiential learning by replicating realistic clinical experiences that can develop learner competencies in a safe environment. Virtual reality simulation may provide the same level of effective and engaging experiential learning in a fully immersive learning environment without many of the limitations inherent to traditional live simulation environments, such as simulation equipment and designated labs.

PROBLEM

While there are vendor-provided resources and a new tool kit covering immersive technology simulation implementation in nursing, a lived example to contextualize the implementation process is missing from the literature.

APPROACH

This article discusses the selection and implementation of virtual reality simulations in a nursing undergraduate program and lessons learned in the process.

CONCLUSIONS

Nurse educators seeking such experiences for their students may benefit from the insights shared in this article.

Exploring in-person self-led debriefings for groups of learners in simulation-based education: an integrative review

BACKGROUND

Facilitator-led debriefings are well-established for debriefing groups of learners in immersive simulation-based education. However, there has been emerging interest in self-led debriefings whereby individuals or groups of learners conduct a debriefing themselves, without the presence of a facilitator. How and why self-led debriefings influence debriefing outcomes remains undetermined.

RESEARCH AIM

The aim of this study was to explore how and why in-person self-led debriefings influence debriefing outcomes for groups of learners in immersive simulation-based education.

METHODS

An integrative review was conducted, searching seven electronic databases (PubMed, Cochrane, Embase, ERIC, SCOPUS, CINAHL Plus, PsychINFO) for peer-reviewed empirical studies investigating in-person self-led debriefings for groups of learners. Data were extracted, synthesised, and underwent reflexive thematic analysis.

RESULTS

Eighteen empirical studies identified through the search strategy were included in this review. There was significant heterogeneity in respect to study designs, aims, contexts, debriefing formats, learner characteristics, and data collection instruments. The synthesised findings of this review suggest that, across a range of debriefing outcome measures, in-person self-led debriefings for groups of learners following immersive simulation-based education are preferable to conducting no debriefing at all. In certain cultural and professional contexts, such as postgraduate learners and those with previous debriefing experience, self-led debriefings can support effective learning and may provide equivalent educational outcomes to facilitator-led debriefings or self-led and facilitator-led combination strategies. Furthermore, there is some evidence to suggest that self-led and facilitator-led combination approaches may optimise participant learning, with this approach warranting further research. Reflexive thematic analysis of the data revealed four themes, promoting self-reflective practice, experience and background of learners, challenges of conducting self-led debriefings and facilitation and leadership. Similar to facilitator-led debriefings, promoting self-reflective practice within groups of learners is fundamental to how and why self-led debriefings influence debriefing outcomes.

CONCLUSIONS

In circumstances where simulation resources for facilitator-led debriefings are limited, self-led debriefings can provide an alternative opportunity to safeguard effective learning. However, their true value within the scope of immersive simulation-based education may lie as an adjunctive method alongside facilitator-led debriefings. Further research is needed to explore how to best enable the process of reflective practice within self-led debriefings to understand how, and in which contexts, self-led debriefings are best employed and thus maximise their potential use.

Using Simulation to Teach Learners in Health Care Behavioral Skills Related to Diversity, Equity, and Inclusion: A Scoping Review

SUMMARY STATEMENT

Bias is commonplace in the health care environment and can negatively impact patients and their health outcomes. Simulation has long been shown to be an effective teaching tool for communication skills in health care, but it has rarely been used to deliver concrete behavioral skills that address issues of diversity, equity, and inclusion (DEI). This scoping review examines 23 published articles surrounding the use of simulation in health care education to impart behavioral skills that reduce bias and promote DEI. Included articles described various behavioral skills including communication, history-taking, and system/community-level advocacy. The most commonly used simulation modality to teach these skills included the use of simulated participants (16 articles, 70%). The main DEI topics addressed in the trainings included sexual orientation/gender identity, language, and culture/ethnicity. Based on findings from this review, the authors suggest recommendations for educators who are considering teaching DEI-related skills through simulation.

Effectiveness of simulation debriefing methods in nursing education: A systematic review and meta-analysis

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate debriefing methods' effectiveness on learning outcomes for nursing students.

DESIGN

A systematic review and meta-analysis were applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.

DATA SOURCES

Publications were searched in PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, and WANFANG (China) databases from inception to 2020.

REVIEW METHODS

Two researchers independently retrieved articles and evaluated their quality. Review Manager version 5.3 software was used to conduct the meta-analysis, following the PRISMA guidelines. Bias risk was assessed using the Joanna Briggs Institute manual. Heterogeneity was assessed by I² statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used for effect size analysis based on learning outcomes.

RESULTS

Sixteen studies were selected in the systematic review and 13 studies with 1637 nursing students were included in the meta-analysis. Five debriefing methods were used in the intervention group. The analysis showed that Debriefing for Meaningful Learning was more effective on the debriefing quality (SMD = 0.52, 95%CI [0.32, 0.72]), and that video-assisted debriefing was more effective on nursing students' experiences (SMD = 0.30, 95%CI [0.02, 0.58]) and critical thinking (SMD = 0.90, 95%CI [0.65, 1.15]) compared with the usual debriefing. However, written debriefing did not show better effects on students' experiences (SMD = -0.22, 95%CI [-0.51, 0.07]), and peer-led debriefing did not show better effects on the debriefing quality compared with the usual debriefing (SMD = -0.15, 95%CI [-1.43, -0.67]).

CONCLUSIONS

The study indicated that Debriefing for Meaningful Learning and video-assisted debriefing showed a positive impact on nursing education. Future studies that have larger sample sizes, high-quality debriefing methods, robust study designs, and other learning outcomes are required.