Comparison of the effects of debriefing methods on psychomotor skills, self-confidence, and satisfaction in novice nursing students: A quasi-experimental study

Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary health professions education: A randomized trial

AIM

We aimed to compare the debriefing experience, simulation assessment, reflection, anxiety and simulation satisfaction of using oral debriefing versus video-assisted debriefing after a simulated clinical session in an interdisciplinary cohort of health sciences students.

BACKGROUND

Debriefing is a reflective process that takes place after a clinical simulation and that can be performed either in a traditional way (oral) or using video-assisted debriefing.

DESIGN

A randomized controlled trial was conducted in 143 health sciences students (35.7% male, 61.5% female).

METHODS

The simulation scenario was designed to evaluate the procedure for donning and doffing personal protective equipment. Differences in debriefing experience, simulation assessment, reflection, anxiety and satisfaction were assessed.

RESULTS

Regarding debriefing experience, significant differences were observed for the category "learning" (34.9 (6.13) vs. 36.7 (3.89); p = 0.039). For simulation assessment, significantly higher scores for all categories were identified in video-assisted debriefing compared with oral debriefing (p<0.001). There were also significant differences between the oral debriefing versus video-assisted debriefing for the overall score of reflection ability (86.97 (10.55) vs. 90.74 (9.67); p=0.028) as well as for the category "reflective communication" (24.72 (3.77) vs 26.04 (4.07); p=0.047). Perceived satisfaction was significantly higher in the video-assisted debriefing group compared with oral debriefing group (p <0.001). For anxiety, no significant differences were observed between debriefing groups.

CONCLUSION

Video-assisted debriefing after a simulated clinical session improves debriefing experience, simulation assessment, reflection and simulation satisfaction, but does not increase anxiety compared with oral debriefing among health sciences students.

Society for Simulation in Healthcare Guidelines for Simulation Training

BACKGROUND

Simulation has become a staple in the training of healthcare professionals with accumulating evidence on its effectiveness. However, guidelines for optimal methods of simulation training do not currently exist.

METHODS

Systematic reviews of the literature on 16 identified key questions were conducted and expert panel consensus recommendations determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.

OBJECTIVE

These evidence-based guidelines from the Society for Simulation in Healthcare intend to support healthcare professionals in decisions on the most effective methods for simulation training in healthcare.

RESULTS

Twenty recommendations on 16 questions were determined using GRADE. Four expert recommendations were also provided.

CONCLUSIONS

The first evidence-based guidelines for simulation training are provided to guide instructors and learners on the most effective use of simulation in healthcare.

The effectiveness of video training in improving intensive care nurses' knowledge about brain death identification

BACKGROUND

Because patients diagnosed with brain death in intensive care units constitute a potential cadaveric donor group for organ transplantation, intensive care units are potential donor sources. Nurses who closely monitor the patient collaborate with medical personnel in the recognition and early diagnosis of brain death. Nurses also have an important role in supporting the patient's family. Therefore, it is very important for nurses to know the diagnostic criteria for brain death.

AIM

The aim of this study was to compare the effectiveness of theoretical education and video-assisted education in equipping intensive care nurses to recognize brain death.

STUDY DESIGN

A randomized, experimental study was conducted between February and May 2020 with a total of 50 intensive care nurses, split into 25 in the video-assisted training group and 25 in the theoretical training group. In study, intensive care nurses were given a theoretical training and video-assisted training on brain death criteria. One group was trained theoretically and the other group used a video showing criteria for brainstem reflexes (pupil assessment, spontaneous breathing, corneal reflex, retching and coughing assessments) and deep tendon reflexes in a simulated patient, supported by animation. The data were collected before, immediately after and 3 months after the training using the Brain Death Criteria Knowledge Test, the Brain Death Case Test, and the Training Effectiveness Evaluation Form. The independent samples t-test, Mann-Whitney U test, Friedman test, Wilcoxon test, and Chi-square test were used for statistical analysis of data.

RESULTS

It was found that the knowledge scores of both groups immediately after training and 3 months after training were higher than before the training (p < .001). However, the post-training knowledge scores of the video-assisted training group were significantly higher than those of the theoretical training group (p = .011).

CONCLUSIONS

To enable intensive care nurses to identify brain death, video-assisted training with a simulated patient is recommended, as is repeating the training at regular intervals.

RELEVANCE TO CLINICAL PRACTICE

The simulated patient video-assisted training method can be used for in-service training to provide intensive care nurses with the ability to identify brain death. The training may be repeated at regular intervals (e.g., every 3 months) to increase nurse recall.

Debriefing Methods for Simulation in Healthcare: A Systematic Review

ABSTRACT

Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature. The PICO question for this review was defined as "In healthcare providers [P], does the use of one debriefing or feedback intervention [I], compared to a different debriefing or feedback intervention [C], improve educational and clinical outcomes [O] in simulation-based education?" We included 70 studies in our final review and found that our current debriefing strategies, frameworks, and techniques are not based on robust empirical evidence. Based on this, we highlight future research needs.

Comparison of real-time feedback and debriefing by video recording on basic life support skill in nursing students

BACKGROUND

Cardiopulmonary resuscitation skill have a direct impact on its success rate. Choosing the right method to acquire this skill can lead to effective performance. This investigation was conducted to compare the effect of Real-time feedback and debriefing by video recording on basic life support skill in nursing students.

METHODS

This quasi-experimental study was performed on 67 first year nursing students. First, a theoretical basic life support (BLS) training session was held for the all participants, at the end of session the pre-test was taken. Students were randomly assigned to two groups. A 4-hour practical BLS training session was conducted in the real - time feedback group as well as the debriefing by video recording group, and at the end of the training, a post-test was taken from each group. Each group received a post-test. Data were analyzed using SPSS 25 software.

RESULTS

Results showed a significant difference between mean (SD) of debriefing by video recording group in pre-test and post-test (p < 0.001) and in the real-time feedback group there was a significant difference between mean (SD) in pre-test and post-test (p < 0.001), respectively. In addition, there was no significant difference between the mean score of basic life support skill in real-time feedback and debriefing by video recording.

CONCLUSIONS

Both real-time feedback and debriefing by video recording were effective on basic life support skill.

Promoting critical thinking through simulation-based healthcare training (SBHT): A scoping review

Background. Critical thinking (CT) is an essential graduate attribute for health professions (HP) students. Yet, achieving a higher level of CT in HP students through education is often difficult for educators. SBHT has proven to be an effective strategy to promote CT, but it is not clear how this educational pedagogy should be implemented to achieve higher levels of CT.Objective. To identify and describe the use of simulation-based healthcare training (SBHT) strategies to promote CT in HP students. Methods. Based on the revised methodology of Levac et al., a scoping review was conducted on studies reporting an improvement in CT through simulation-based healthcare education published between January 2010 and August 2021.Results. Twenty articles were included. Through thematic analysis, three main themes were identified: contact simulations, computer-based simulations, and debriefing. The focus was on how these approaches were used to promote CT. Various subthemes were also identified. Conclusion. Correctly planning and implementing a simulation-based experience that relates to the relevant learning activities, combined with repeat practice and guided reflection during the debriefing stage, improves the CT skills of HP students.

Effects of simulation technology-based learning on nursing students' learning outcomes: A systematic review and meta-analysis of experimental studies

BACKGROUND

Gaps between theory and clinical practice represent challenges for nursing students during their learning processes. Providing simulation technology-based learning for nursing students is essential for modern nurse education, but evidence of efficacy remains scarce.

OBJECTIVES

To determine the effects of simulation technology-based learning for nursing students.

DESIGN

A systematic review and meta-analysis.

METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Five databases (CINAHL, Embase, MEDLINE, PubMed, and Web of Science) were electronically searched through May 30, 2021. Eligibility criteria included nursing students, simulated technology-based learning as the primary intervention, and randomised controlled trials or quasi-experimental studies published in English. The methodological quality of included studies was evaluated by the Cochrane risk-of-bias tool. Comprehensive Meta-Analysis Version 3.0 was used to conduct a meta-analysis using the random-effects model. Begg's and Egger's tests were performed to assess publication bias, and sensitivity analysis performed using a remove one study method.

RESULTS

A total of 17 studies were included in this study. Simulated technology-based learning significantly increased nursing student knowledge acquisition (standard mean difference [SMD]: 0.72, 95% confidence interval [CI]: 0.25-1.18, p < 0.001), enhanced student's confidence (SMD: 0.50, 95% CI: 0.02-0.99, p = 0.043), and increased student's satisfaction in learning (SMD: 0.81, 95% CI: 0.61-1.00, p < 0.001). Subgroup analyses showed that receiving simulation by manikins simulator had a greater effect on knowledge acquisition (SMD: 1.01, 95% CI: 0.27-1.74, p = 0.007).

CONCLUSIONS

Simulation technology use may meet the expectations of undergraduate nursing students and prepare them for clinical practice, representing an opportunity to fill gaps between theory and clinical practice while simultaneously developing new teaching scenarios.

Stress level experienced by participants in realistic simulation: a systematic review

OBJECTIVES

to identify the available evidence regarding stress levels experienced by participants in education based on a realistic simulation.

METHODS

systematic review that included randomized clinic trials on electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Latin-American and Caribbean Literature in Health Sciences, LIVIVO, PubMed, Scopus, and Web of Science. The additional search was performed on Google Scholar and OpenGrey. All searches occurred on September 24, 2020. The methodologic quality of the results was evaluated by the Cochrane Collaboration Risk of Bias Tool.

RESULTS

eighteen studies were included, which evaluated the participants' stress using physiologic, self-reported measures, or the combination of both. Stress as experienced in a high level in simulated scenarios.

CONCLUSIONS

evidence of the study included in this systematic review suggest that stress is experienced in a high level in simulated scenarios.

Simulation effectiveness tool modified (SET-M): adaptation and validation for Brazil

Objective:

to adapt the Simulation Effectiveness Tool - Modified (SET-M) to Portuguese and to verify validity and reliability indexes.

Method:

methodological study using ISPOR, Confirmatory Factor Analysis, correlation between the adapted instrument/Simulation Design Scale - Student Version/Individual Practice Assessment and reliability (test-retest and internal consistency indexes). Convenience sample with a total of 435 Nursing undergraduate and graduate students.

Results:

Simulation Effectiveness Tool - Modified Brazilian Version obtained an average score between 2.36 to 2.94. The Confirmatory Factor Analysis had a factor load > 0.30 for 17 of the 19 items. Cronbach’s alpha ranged between 0.729 and 0.874. McDonald’s omega was 0.782. There was no correlation between Simulation Effectiveness Tool - Modified Brazilian Version and the Simulation Design or Individual Practical Assessment. There was a positive correlation between the Simulation Effectiveness Tool - Modified Brazilian Version and the participants’ age. The scores of the volunteers in the simulations were significantly higher than those of the observers in three domains.

Conclusion:

the SET-M Brazilian Version, maintaining the 19 items and four domains of the original scale, was made available for use in Brazil to evaluate the effectiveness of the simulation, recommending studies with different samples.

A Combination of Self-debriefing and Instructor-led Debriefing Improves Team Effectiveness in Health Science Students

BACKGROUND

Debriefing is considered a critical component of simulation-based learning, but the differences between different debriefing methods remain unclear.

PURPOSE

The purpose of the study was to investigate the effectiveness of the debriefing assessment, problem-solving process, and team effectiveness among students who received instructor-led debriefing, self-debriefing, and combined debriefing.

METHODS

An experimental design was conducted with 250 students (nursing, physiotherapy, and occupational therapy). Differences in the Debriefing Experience Scale (DES), Problem Solving Inventory (PSI), and Communication and Teamwork Skills (CATS) assessment between the groups were measured.

RESULTS

In nursing students, the combined debriefing group had the highest scores for the CATS assessment (P < .001) and for the coordination (P < .001), cooperation (P = .012), and communication (P = .002) categories. No significant differences were observed between debriefing groups for DES or PSI.

CONCLUSIONS

Combined debriefing improves communication and team skills in students. Educators might promote combined debriefing after simulation sessions as it seems to improve team effectiveness.

Peer Debriefing Versus Instructor-Led Debriefing for Nursing Simulation

BACKGROUND

Debriefing is the reflective process following the simulation experience. We aimed to compare the debriefing assessment and debriefing satisfaction perceived by nursing students who underwent different debriefing methods.

METHOD

An experimental study conducted on three groups (instructor-led debriefing, peer debriefing, and combined debriefing) was performed for 177 nursing students. Differences in the debriefing satisfaction were assessed using the Clinical Experience Simulation scale, the Visual Analogue scale, and the Debriefing Assessment for Simulation in Healthcare (DASH).

RESULTS

VAS scores for satisfaction differed significantly between the instructor-led debriefing, peer debriefing, and combined debriefing groups. In the Clinical Experience Simulation scale, the combined debriefing group was significantly higher compared with instructor-led debriefing. The total score for DASH was significantly higher in the combined debriefing group compared with instructor-led debriefing, and in instructor-led debriefing compared with peer debriefing.

CONCLUSION

Combining debriefing after a simulation session improves the debriefing satisfaction and the perceived debriefing assessment among nursing students. [J Nurs Educ. 2021;60(2):90-95.].

Effect of simulation modules on Jordanian nursing student knowledge and confidence in performing critical care skills: A randomized controlled trial

BACKGROUND

Simulation is known to have a significant effect as a teaching strategy in nursing education. However, no studies have been conducted to examine the effect of simulation on nursing students' knowledge and confidence in performing critical care skills in Jordan.

PURPOSE

This study aimed to test the effect of simulation on university nursing students' knowledge and confidence in performing critical care skills for patients with cardiac, respiratory and neurological health problems.

METHOD

A randomized controlled (pre-test-post-test) design was implemented. The experimental group (n = 38) attended 9 simulation scenarios, theoretical lectures and clinical training in hospital about cardiac, respiratory and neurological health problems, while the control group (n = 38) attended only the theoretical lectures and clinical training in hospital. Knowledge and confidence were measured using knowledge exam and self-confidence scale respectively.

RESULTS

A paired t-test indicated that mean knowledge and confidence regarding implementing critical care skills were significantly higher P < 0.001 in the post-test than that in the pre-test, in both the experimental and the control group. However, independent t test revealed that the students in the experimental group scored significantly higher P < 0.001 than control group in both knowledge and confidence regarding performing critical care skills.

CONCLUSION

Theoretical and clinical training is valuable teaching strategies that help enhance knowledge and confidence in applying critical care skills. However, adding simulation has a more significant effect than theoretical and clinical training in improving nursing students' knowledge and confidence in performing critical care nursing skills. Author strongly recommended considering simulation as alternative effective educational approach for clinical training especially during COVID-pandemic.