Lavoie Patrick, Pepin Jacinthe, Boyer Louise
Dynamics. 2013 Winter;24(4):36-41.
Novice nurses are increasingly beginning their career paths in critical care areas, where they are expected to care for patients whose lives are potentially threatened. They are unable to benefit from years of experience to facilitate their clinical decisions. Reflection after simulation could possibly improve nurses' clinical judgment in complex situations.
An educational project was conducted to pilot-test a teaching intervention, which combined reflective debriefing with a simulated critical care experience.
Five nurses beginning in an intensive care unit participated in the pilot test. Their perception of their learning and satisfaction with the reflective debriefing and the simulation were collected using open-ended questionnaires. A clinical nurse educator, a faculty member and the first author participated in a group discussion to review the time plan and the affective components of the teaching intervention.
Participants reported that the reflective debriefing helped them understand their cognitive processes during the simulation and contributed to clinical judgment development and to their care prioritization and assessment capacities. Observers reported the time plan was adequate and that attention to participants' negative feelings was necessary.
The results of this pilot test provide preliminary information that reflective debriefing may be a safe and potentially effective way for novice critical care nurses to learn from a clinical experience and enhance clinical judgment.
新手护士越来越多地在重症监护领域开启他们的职业生涯，在这些领域他们需要护理生命可能受到威胁的患者。他们无法从多年的经验中受益来辅助临床决策。模拟后的反思可能会提高护士在复杂情况下的临床判断力。
开展了一个教育项目，对一种教学干预措施进行试点测试，该措施将反思性汇报与模拟重症监护体验相结合。
五名刚开始在重症监护病房工作的护士参与了试点测试。通过开放式问卷收集她们对学习的认知以及对反思性汇报和模拟体验的满意度。一名临床护士教育工作者、一名教员和第一作者参与了小组讨论，以审查教学干预措施的时间安排和情感因素。
参与者报告称，反思性汇报帮助他们理解了模拟过程中的认知过程，有助于临床判断力的发展以及护理优先级和评估能力的提升。观察者报告称时间安排是合适的，并且关注参与者的负面情绪是必要的。
本次试点测试的结果提供了初步信息，即反思性汇报可能是新手重症监护护士从临床经验中学习并提高临床判断力的一种安全且可能有效的方式。
