Browsing by Subject "Debriefing"

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    Debriefing For Meaningful Learning: Fostering Development of Clinical Reasoning Through Simulation
    (2011-02-25) Dreifuerst, Kristina Thomas; Jeffries, Pamela R.; Horton-Deutsch, Sara L.; McNelis, Angela M.; Pesut, Daniel J.
    There is a critical need for faculty, a shortage of clinical sites, and an emphasis on quality and safety initiatives that drive increasing use of simulation in nursing education. Debriefing is an essential component of simulation, yet faculty are not consistently prepared to facilitate it such that meaningful learning, demonstrated through clinical reasoning, occurs from the experience. The purpose of this exploratory, quasi-experimental, pre-test-post-test study was to discover the effect of the use of a simulation teaching strategy, Debriefing for Meaningful Learning (DML), on the development of clinical reasoning in nursing students. Clinical reasoning was measured in 238 participant students from a Midwestern university school of nursing taking an adult health course that uses simulation. Participants were assigned to either the experimental or control group where the DML was compared to customary debriefing using the Health Sciences Reasoning Test (HSRT) before and after the debriefing experience, and the Debriefing Assessment for Simulation in Healthcare©–Student Version (DASH©–SV) with four supplemental questions about the DML (DMLSQ) process, during the post-debriefing assessment. This research sought to understand if the DML debriefing strategy positively influenced the development of clinical reasoning skills in undergraduate nursing students, as compared to usual and customary debriefing. The data revealed that there was a statistical difference between total mean test scores measured by the HSRT. There was, additionally, statistical significance in the change in scores between pre-test and post-test for those who used the DML as compared to the control. There was also a difference in the student’s perception of the quality of the debriefing measured by the DASH©–SV with the DML rated statistically higher than usual debriefing. Finally, there was a significant correlation, demonstrated through regression analysis, between the change in HSRT scores and students’ perception of quality debriefing and the use of the DML. This study contributes to the growing body of knowledge about simulation pedagogy, provides tools for use in debriefing, and informs faculty on best practices in debriefing.
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    Exploring faculty preparation for and use of debriefing with the debriefing for meaningful learning inventory
    (2016-07-19) Bradley, Cynthia Diane; Dreifuerst, Kristina Thomas; Ironside, Pamela M.; Wonder, Amy Hagedorn; Friesth, Barbara Manz; Jeffries, Pamela R.
    Debriefing is the most significant component of simulation, yet the impact of debriefer training for this critical time of learning has not been reported. Although training of debriefers in the use of a structured debriefing method has been recommended by nursing organizations and regulating bodies, a description of the impact of training on the understanding and application of debriefing within nursing programs is largely unknown. Debriefing for Meaningful Learning© (DML) is a structured, evidencebased debriefing method that promotes the development of clinical reasoning among prelicensure nursing students. DML has been adopted for use across the curriculum throughout nursing education. However, little is known regarding how debriefers are trained in this method and how that training impacts their understanding and application of the method. The DML Inventory (DMLI), was developed and tested for this research study, and used to assess and document 234 debriefers’ understanding of the central concepts of DML and subsequent application of DML behaviors during simulation debriefing with prelicensure baccalaureate nursing students. Statistically significant differences were found between those debriefers who had and had not been trained in DML. Statistically significant differences were also found in the understanding of the DML central concepts, and in the application of DML based on the types of training the debriefers received. viii The data indicate that DML trained debriefers consistently apply more DML behaviors than those who had not received training, and that multiple sources of training resulted in a more consistent application of DML debriefing behaviors. Furthermore, understanding the central concepts of DML resulted in debriefers consistently applying more debriefing behaviors consistent with the DML design. This study contributes to the growing body of knowledge of debriefing in nursing education and training in evidence-based debriefing methods, by providing a tested instrument that can be used to assess debriefers using DML. The findings also demonstrate the impact of the type of training on how structured debriefing methods are then implemented in teaching-learning environments, which can be used to improve future training.
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    Observational experiential learning facilitated by debriefing for meaningful learning : exploring student roles in simulation
    (2018-07-25) Johnson, Brandon Kyle; Reising, Deanna L.; Wonder, Amy Hagedorn; Friesth, Barbara Manz; Byrne, Bobbi J.
    Simulation is an educational strategy used in prelicensure nursing education that has been demonstrated to effectively replace selected clinical experiences. Simulation experiences may include the use of differing roles including the active participant, who makes decisions during the simulation and the passive observer, who watches the simulation unfold. There is a lack of rigorous research testing whether students in the passive observer role during simulations demonstrate and retain knowledge similarly to those in active participant roles. In addition, differences in knowledge applied to a contextually similar case between those who actively participate and passively observe have not been studied. The purpose of this study was to explore the relationship between nursing student’s roles in simulation and cognitive knowledge demonstration, retention, and application about two contextually similar cases of respiratory distress. An experimental, pretest-multiple posttest, repeated measures study was conducted with a convenience sample of 119 baccalaureate prelicensure nursing students from a large multi-campus Southwestern university. Two knowledge instruments were administered throughout different stages of the simulation and four weeks later. Associations between role in simulation and scores on the knowledge instruments were examined using t-tests and mixed repeated measures-analysis of variance. Of the 59 active participants and 60 observers, there were no significant differences in knowledge demonstrated or retained after simulation, after debriefing, or four weeks later. Additionally, there were no significant differences in knowledge demonstrated when applied to a contextually similar case after debriefing or four weeks later between active participant and observer. Future research is needed to examine these relationships in larger and more diverse samples and different contextual clinical situations in simulation. These results will contribute to the further testing and implementation of using observation as a strategy for teaching and learning with simulation for nursing and health professions education.