Structured debriefing: What difference does it make?

Debriefing in simulation is a cornerstone of learning. However, in-depth studies examining simulation debriefing are scarce. This study explored four key debriefing attributes-feedback, reflection, knowledge development, and psychological safety-prior and subsequent to the implementation of a new pedagogical intervention in a pre-clinical scenario simulation course. The scenarios focused on patients with deteriorating conditions and took place at bachelor's nursing degree level. The new intervention for the debriefing sessions contained a detailed observation tool describing specific, correct nursing actions for deteriorating patients; video playback watched only by students acting as nurses, and debriefing organized into two sections. The study design was explorative. To generate data, 12 debriefing sessions were audio and video recorded in 2013 and 11 in 2014. Two student groups participated each year, comprising 16 and 10 students, respectively. Qualitative analysis was performed to examine the transcribed audio and video recordings. Relative to the 2013 cohort, the reflections of observers and the students acting as nurses were more assertive, and students' feedback was more specific and comprehensive in the 2014 cohort. Conducting in-depth studies examining debriefing is important to increase knowledge regarding the impact of pedagogical underpinnings on debriefing content and processes.