Debriefing for Professional Practice Placements in Nursing: A Concept Analysis

Entry to practice nursing students' experiences of debriefing during clinical practice: A qualitative meta-synthesis

OBJECTIVES

The objectives of this review were to identify, explore and synthesize existing evidence in the literature of nursing students' experiences of debriefing in their clinical practice placements.

DESIGN

Qualitative meta-synthesis.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, and Scopus. Qualitative studies were considered for inclusion if published in English, reporting primary data analysis including experiences of nursing students. The final search was conducted on 22 October 2021, no time limit was applied.

REVIEW METHODS

Qualitative studies were identified and appraised. Across the included studies, authors' themes and metaphors, and participant quotes were inductively analysed and interpreted, then expressed in the synthesis.

RESULTS

Three new themes representing nursing students' experiences of debriefing were constructed. Theme one, 'It didn't happen formally, but I needed it', included students expressing the value of, and wanting to be involved in, debriefing to gain validation, reassurance, and guidance. Theme two, 'I had to release it and it helped' included students' positive experiences of debriefing with another student, nurse, or confidant, through various modalities. These experiences affirmed they were not alone in their feelings, which provided relief, confidence, and new ways of thinking and practicing. Theme three, 'Strengthened clinical experience and learning', included students feeling debriefing supported their awareness and understanding of practice and increased participation in clinical experiences. This awareness and understanding provided an opportunity for students to explore, and reflect on, the impact of patient care.

CONCLUSIONS

Through debriefing student nurses found relief, confidence, and new ways of thinking through a shared understanding. Debriefing supported student learning and the clinical-academic education team had a key role in creating this opportunity.

Prevalence and Associated Factors of Burnout Risk Among Intensive Care and Emergency Nurses Before and During the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Study in Belgium

INTRODUCTION

This study aimed to assess (1) the prevalence of burnout risk among nurses working in intensive care units and emergency department before and during the coronavirus disease 2019 pandemic and (2) the individual and work-related associated factors.

METHODS

Data were collected as part of a cross-sectional study on intensive care unit and emergency nurses in Belgium using 2 self-administered online questionnaires distributed just before the pandemic (January 2020, N = 422) and during the first peak of the pandemic (April 2020, N = 1616). Burnout was assessed with the Maslach Burnout Inventory scale.

RESULTS

The overall prevalence of burnout risk was higher among emergency nurses than intensive care unit nurses but was not significantly different after the coronavirus disease 2019 pandemic (from 69.8% to 70.7%, χ² = 0.15, P = .68), whereas it increased significantly among intensive care unit nurses (from 51.2% to 66.7%, χ² = 23.64, P < .003). During the pandemic, changes in workload and the lack of personal protective equipment were significantly associated with a higher likelihood of burnout risk, whereas social support from colleagues and from superiors and management were associated with a lower likelihood of burnout risk. Several determinants of burnout risk were different between intensive care unit and emergency nurses.

CONCLUSION

Our findings indicate that nurses in intensive care unit and emergency department were at risk of burnout but their experience during the coronavirus disease 2019 pandemic was quite different. Therefore, it is important to implement specific measures for these 2 groups of nurses to prevent and manage their risk of burnout.

Nursing and paramedicine student and academic perceptions of the two phase debrief model: A thematic analysis

Simulation debriefing standards and models recommend simulation facilitators spend time debriefing learner feelings and clinical reasoning following the simulation scenario. Many debriefing models are available, more so in nursing than in paramedicine, however few models combine specific frameworks to debrief learner feelings and unpack cognitive decisions. The Two Phase Debrief model was designed to support debriefers to spend equal amounts of time debriefing learner felt reactions and clinical decision making, guided by specific tools and skills for each phase. Australian nursing and paramedicine students (n = 19) and academics (n = 9) evaluated the Two Phase Debrief model using a qualitative descriptive design. Analysis of focus group data revealed three themes: Valuing time for debrief, Valuing skills for debrief and Valuing emotions. Across the two disciplines, academics agreed learners would benefit from debriefing using Two Phase Debrief model but considered time a barrier. Nursing and paramedicine students felt the equal time spent exploring emotions and clinical reasoning contributed to a positive learning experience and that expert debriefers may not need disciplinary specific content knowledge. These and other findings discussed indicate there is more work needed to understand the appetite for and required skills of expert cross disciplinary simulation debriefing teams.