The Essentials of Debriefing and Reflective Practice.

Debriefing is a specific type of reflective learning. Debriefing follows an experience, with the goal of taking meaningful learning away from the experience. It is often used following a simulation-based educational experience but the same techniques can be used following actual clinical care. Early studies in simulation suggest that learning does not occur in simulation-based education in the absence of debriefing. There are phases of a debriefing discussion and specific conversational strategies that are used to engage learners and provoke engaging learning discussions. Standards of practice call for facilitators with specialized training and a debriefing method that is theory based.

Simulation for Competency Development in Clinical Practice.

Nursing education at the undergraduate and graduate levels is undergoing a transformational curricular change that includes moving toward a competency-based curriculum. This opportunity holds promise to close the education-practice gap that has plagued nursing education for decades. A key teaching modality to achieve this outcome is simulation-based education. This article will explore the interaction between simulation and competency-based education.

Teaching, coaching, or debriefing With Good Judgment: a roadmap for implementing "With Good Judgment" across the SimZones.

Simulation-based learning occurs in multiple contexts, and one teaching style cannot adequately cover the needs at each learning level. For example, reflective debriefing, often used following a complex simulation case, is not what is needed when learning new skills. When to use which facilitation style is a question that educators often overlook or struggle to determine. SimZones is a framework used to clarify the multiple contexts in simulation. This framework, combined with elements of Debriefing With Good Judgment, can help educators match the appropriate facilitation style with learner needs and learning context. We have distilled the core elements of the "with good judgment" approach to debriefing and applied them to the SimZones framework to guide educators with (1) what type of learning can be expected with each learning context, (2) what behaviors and activities can be expected of the learners in each learning context, (3) what instructional strategies are most effectively used at each stage, and (4) what are the implications for the teacher-learner relationship.

Fostering Civility in Learning Conversations: Introducing the PAAIL Communication Strategy.

BACKGROUND: Civility, psychological safety, and effective stress management are essential for meaningful learning conversations. PROBLEM: Incivility triggers fear and humiliation, impairs clinical judgment and learning, reduces psychological safety, and increases cognitive load. These factors converge to make learners less likely to incorporate feedback, speak up when there is a problem, and discuss practice errors and patient safety issues. APPROACH: The authors combined the Basic Assumption and the PAAIL (Preview, Advocacy1, Advocacy2, Inquiry, and Listen) conversational strategy to help surface (rather than obscure) both educators' and learners' thinking. The synergy of these 2 strategies allows educators to identify individual learning needs and develop the learners' clinical judgment skills. This process improves learning by reducing incivility and cognitive load, improving psychological safety, and strengthening clinical judgment skills. CONCLUSION: This conversational strategy can minimize stress and anxiety in learners and optimize learning.

Evidence-Based Debriefing.

Ongoing shifts in the healthcare system require practitioners who possess metacognitive skills to evaluate their decisions and the thinking and rationale guiding those decisions. In an effort to design learning activities that support metacognition in nursing education, undergraduate and graduate faculty, are embracing simulation-based education (SBE) as an effective teaching and learning strategy. SBE includes prebriefing, the simulation scenario, and debriefing, all of which are supported by psychological safety. Prebriefing precedes the entire learning process and is integral to engagement in the simulation and to the effectiveness of the debriefing. Debriefing provides educators with the opportunity to explore and develop those metacognitive skills with learners. In this chapter on evidence-based debriefing, the authors will explore the evidence and theories surrounding best practices in SBE, specifically the prebriefing and debriefing components of the learning experience. The chapter explores the theoretical foundation of SBE and theory-based debriefing; educational best practices of prebriefing as an integral part of an effective debriefing; theory-based debriefing models; research evidence of debriefing outcomes; evaluation of the prebriefing and debriefing process; and finally, provides recommendations on the priorities for further research in debriefing. Within this chapter, the term educator is inclusive of undergraduate, graduate, and professional development nurse educators and reflects the educator role in SBE.

Debriefing Practices in Nursing Education Programs: Results from a National Study.

AIM: The purpose of the study was to describe debriefing practices in nursing education programs in the United States. BACKGROUND: Despite the acknowledged importance of debriefing, little is known about debriefing practices. It is imperative that debriefing practices be examined in order to establish a baseline understanding of current practice. METHOD: The study design was a cross-sectional Internet-based survey. Surveys were sent to every accredited pre-licensure nursing program in the United States. Regression analysis determined variables that were associated with the use of theory-based debriefing. RESULTS: Data analysis determined that most debriefers do not have training in debriefing and that their competence was not assessed. Factors associated with the use of theory-based debriefing included the presence of a designated simulation administrator, training for debriefers, and competence assessment of debriefers. CONCLUSION: These results establish a baseline from which to prioritize faculty development in simulation-based education.