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

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.

Using Clinical Instructor Perceptions to Improve a Pilot Simulation Course

Little is known about clinical instructors' perceptions of student decision-making in relation to the block sequencing of simulation and traditional clinical experiences. Focus groups were conducted with 12 clinical instructors. Three common threads emerged from the data: right away, anxious but more confident, and scary and unsafe. Instructors noted that the more patient care experiences encountered, the more students developed efficient clinical decision-making skills. Major safety concerns regarding medication administration were identified, resulting in additional safety parameters instituted in the simulated environment.

Innovation in Clinical Course Delivery and Impact on Students' Clinical Decision-Making and Competence

The purpose of this study was to explore the differences in clinical decision-making and clinical competence between two different cohorts of graduating baccalaureate nursing students from a traditional prelicensure program in the United States. A quasi-experimental design was used to compare students who had substituted their traditional medical-surgical clinical experiences with simulation (Cohort 1, n = 35) with students who had supplementary simulation in addition to their traditional clinical experiences (Cohort 2, n = 36). The findings demonstrated that when simulation was used as a supplement to traditional clinical experiences, participants performed better patient assessments.

The impact of simulation sequencing on perceived clinical decision making

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources.