Capturing Debriefing and Enhancing Reflection within Simulated Clinical Learning Environments
This article presents findings from an evaluation of a new A3-size learner notes sheet designed for use by healthcare students engaging in clinical simulation and clinical skills sessions. The notes sheet consists of an adapted form of the SBAR (situation, background, assessment, response) tool, whilst capturing post-simulation oral debriefing provided by a facilitator. Additionally, the Driscoll (2007)model is used to provide students with an opportunity to reflect on their engagement in clinical simulation. Two cohorts of students, who engaged in separate simulation sessions, completed the A3 sheet. The study featured 33 midwifery and 21 operating department practitioner (ODP) students undertaking a simulation. Documentary analysis was undertaken to identify the depth of reflective writing of both groups of students. Midwifery student participants reflected on their experiences of simulation at a slightly deeper level than their ODP counterparts. All students adhered to the structure of the notes sheet when receiving their briefing from the facilitator and when asked to write their reflective accounts. This study has sought to explore an under-researched area of clinical simulation: the extent to which healthcare students can utilise reflection when engaging with a clinical scenario within a simulated learning environment.
Alinier, G. (2003). Nursing students’ and lecturers’ perspectives of objective structured clinical education incorporating simulation. Nurse Education Today, 23(6), 419-426. https://doi.org/10.1016/S0260-6917(03)00044-3
Brush, T. A, & Saye, J. W. (2002). A summary of research exploring hard and soft scaffolding for teachers and students using a multimedia supported learning environment. Journal of Interactive Online Learning, 1(2), 1–12. https://www.ncolr.org/jiol/issues/pdf/1.2.3.pdf
Bucknall, T. K., Forbes, H., Phillips, N. M., Hewitt, N. A., Cooper, S., & Bogossian, F. (2016). An analysis of nursing students’ decision-making in teams during simulations of acute patient deterioration. Journal of Advanced Nursing, 72(10), 2482–2494. https://doi.org/10.1111/jan.13009
Cantrell, M. A. (2008). The importance of debriefing in clinical simulations. Clinical Simulation in Nursing, 4(2), e19–e23. https://doi.org/10.1016/j.ecns.2008.06.006
Coffey F., (2015). Learning by simulation – is it a useful tool for midwifery education? New Zealand College of Midwives Journal, 51, 30–36. https://doi.org/10.12784/nzcomjnl51.2015.5.30-36
Cooper, S., Cant, R., Porter, J., Bogossian, F., McKenna, L., Brady, S. M., & Fox-Young, S. (2012). Simulation based learning in midwifery education: A systematic review. Women and Birth, 25(2), 64–78. https://doi.org/10.1016/j.wombi.2011.03.004
Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. Sage.
Driscoll, J. (2007). Practising clinical supervision: A reflective approach for healthcare professionals (2nd ed.). Elsevier.
Dunn, L., Tyas, M., & Garside, J. (2016). Preregistration students’ reactions to simulation as an education approach within an operating department practitioner curriculum: A qualitative review. Clinical Simulation in Nursing, 12(5), 147–151. https://doi.org/10.1016/j.ecns.2015.12.012
Fero, L. J., O’Donnell, J. M., Zullo, T. G., DeVito Dabbs, A., Kitutu, J., Samosky, J. T., & Hoffman, L. A. (2010). Critical thinking skills in nursing students: Comparison of simulation‐based performance with metrics. Journal of Advanced Nursing, 66(10), 2182–2193. https://doi.org/10.1111/j.1365-2648.2010.05385.x
Forneris, S. G, Neal, D. O., Tiffany, J., Kuehn, M. B., Meyer, H. M., Blazovich, L. M., Holland, A. E., & Smerillo, M. (2015). Enhancing clinical reasoning through simulation debriefing: A multisite study. Nursing Education Perspectives, 36(5), 304–310. https://doi.org/10.5480/15-1672
Gore, A., Leasure, A. R., Carithers, C., & Miller, B. (2015). Integrating hand-off communication into undergraduate nursing clinical courses. Journal of Nursing Education and Practice, 5(4), 70–76. https://doi.org/10.5430/jnep.v5n4p70
Gray, D. E. (2014). Doing research in the real world (3rd ed.). Sage.
Hatton, N., & Smith, D. (1995). Reflection in teacher education: Towards definition and implementation. Teaching and Teacher Education, 11(1), 33–49. https://doi.org/10.1016/0742-051X(94)00012-U
Jensen, R. (2013). Clinical reasoning during simulation: Comparison of student and faculty ratings. Nurse Education in Practice, 13(1), 23–28. https://doi.org/10.1016/j.nepr.2012.07.001
Kember, D., McKay, J., Sinclair, K., & Wong, F. K. Y. (2008). A four-category scheme for coding and assessing the level of reflection in written work. Assessment & Evaluation in Higher Education, 33(4), 369–379. https://doi.org/10.1080/02602930701293355
Lavoie, P., Pepin, J., & Cossette, S. (2017). Contribution of a reflective debriefing to nursing students’ clinical judgment in patient deterioration simulations: A mixed-methods study. Nurse Education Today, 50, 51–56. https://doi.org/10.1016/j.nedt.2016.12.002
Lewis, D. Y., & Ciak, A. D. (2011). The impact of a simulation lab experience for nursing students. Nursing Education Perspectives, 32(4), 256–258. https://doi.org/10.5480/1536-5026-32.4.256
Mackey, S., Tan, K. K., Ignacio, J., Palham, S., Dawood, R. B. M., & Liaw, S. Y. (2014). The learning experiences of senior student nurses who take on the role of standardised patient: A focus group study. Nurse Education in Practice, 14(6), 692–697. https://doi.org/10.1016/j.nepr.2014.10.003
McCulloch, G. (2012). Documentary methods. In J. Arthur, M. Waring, R. Coe, & L. V. Hedges (Eds.), Research methods & methodologies in education (pp. 210–214). Sage.
Meakim, C., Boese, T., Decker, S., Franklin, A. E., Gloe, D., Lioce, L., Sando, C. R., & Borum, J. C. (2013). Standards of best practice: Simulation standard I: Terminology. Clinical Simulation in Nursing, 9(6), S3–S11. https://doi.org/10.1016/j.ecns.2013.04.001
Moon, J. A. (2004). A handbook of reflective and experiential learning: Theory and practice. RoutledgeFalmer.
Muldoon, K., Biesty, L., & Smith, V. (2014). ‘I found the OSCE very stressful’: Student midwives’ attitudes towards an objective structured clinical examination (OSCE). Nurse Education Today, 34(3), 468–473. https://doi.org/10.1016/j.nedt.2013.04.022
NHS Improvement. (2018). Online library of Quality Service Improvement and Redesign Tools: SBAR Communication tool. ACT Academy. https://improvement.nhs.uk/documents/2162/sbar-communication-tool.pdf
Orland-Barak, L. (2005). Portfolios as evidence of reflective practice: What remains ‘untold’. Educational Research, 47(1), 25–44. https://doi.org/10.1080/0013188042000337541
Pike, T., & O’Donnell, V. (2010). The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. Nurse Education Today, 30(5), 405–410. https://doi.org/10.1016/j.nedt.2009.09.013
Plack, M. M, Driscoll, M., Blissett, S., McKenna, R., & Plack, T. P. (2005). A method for assessing reflective journal writing. Journal of Allied Health, 34(4), 199–208. https://www.ingentaconnect.com/contentone/asahp/jah/2005/00000034/00000004/art00004
Shinnick, M. A., Woo, M., Horwich, T. B., & Steadman, R. (2011). Debriefing: the most important component in simulation? Clinical Simulation in Nursing, 7, e105-e111. https://doi.org/10.1016/j.ecns.2010.11.005
Thomas, C. M, Bertram, E., & Johnson, D. (2009). The SBAR communication technique: Teaching nursing students professional communication skills. Nurse Educator, 34(4), 176–180. https://doi.org/10.1097/NNE.0b013e3181aaba54
Wickers, M. P. (2010). Establishing the climate for a successful debriefing. Clinical Simulation in Nursing, 6(3), e83–e86. https://doi.org/10.1016/j.ecns.2009.06.003
Wong, F. K. Y., Kember, D., Chung, L. Y. F., & Yan, L. (1995). Assessing the level of student reflection from reflective journals. Journal of Advanced Nursing, 22(1), 48–57. https://doi.org/10.1046/j.1365-2648.1995.22010048.x
Copyright (c) 2020 Dr Mark Philip Wareing, Jacqueline A England, Dr David Mathew, Carla Ball, Amanda Willetts, Jane Kemp, Kelly Clifford, Andrea Thompson, Ian Dove, Louise Adams
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons License "Attribution-NonCommercial No Derivs 4.0 International" (CC BY-NC-ND 4.0) which permits others to use the publication as long as the authors are appropriately cited.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- The Author grants to Coventry University an irrevocable, royalty-free, worldwide, non-exclusive licence to publish this article in this journal in addition to the licence granted at paragraph 1 of this copyright notice.