Nambu University Department of Nursing, Gwangju, South Korea.
Chosun University Department of Nursing, Gwangju, South Korea.
Nurse Educ Pract. 2021 Jan;50:102962. doi: 10.1016/j.nepr.2020.102962. Epub 2020 Dec 24.
Debriefing, based on reflection, is imperative in simulation. Mezirow's transformative learning theory (TLT) uses critical reflection in providing care to patients, which involves clinical judgment in nursing. The aim of this study was to compare the effects of TLT-versus a non-TLT-based debriefing protocol on knowledge, problem-solving process, critical thinking disposition, and clinical judgment in nursing students. A randomized controlled trial was performed. Fifty-six junior nursing students were assigned to the TLT (n = 26) and the control (n = 30) groups in South Korea. Debriefing protocols based on Mezirow's TLT for the experimental group and gather-analyze-summarize-based debriefing for the control group were used for four weeks. Scores of the TLT group were significantly higher than those of the control group in the problem-solving process, critical thinking disposition, and clinical judgment of reflection. We identified the main effects of group, time, and time-by-group interaction for clinical judgment (noticing, interpreting, and responding), except for knowledge between the two groups. The TLT debriefing approach in simulation can be tailored to improve problem-solving, critical thinking, and clinical judgment outcomes, which are vital to nursing education related to the provision of care to patients.
反思式讨论在模拟教学中至关重要。迈泽罗的变革学习理论（TLT）在为患者提供护理时使用批判性反思，这涉及护理中的临床判断。本研究旨在比较 TLT 与非 TLT 为基础的讨论方案对护理专业学生知识、解决问题的过程、批判性思维倾向和临床判断的影响。采用随机对照试验。56 名初级护理学生在韩国被分配到 TLT（n=26）和对照组（n=30）。实验组采用基于迈泽罗 TLT 的讨论方案，对照组采用以收集-分析-总结为基础的讨论方案，为期四周。TLT 组在解决问题的过程、批判性思维倾向和反思的临床判断方面的得分明显高于对照组。我们确定了两组之间在临床判断（注意、解释和反应）方面除知识外，组间、时间和时间-组间交互作用的主要影响。模拟教学中的 TLT 讨论方法可以定制，以提高解决问题、批判性思维和临床判断的结果，这对与为患者提供护理相关的护理教育至关重要。
