MOVING TOWARDS BEST SIMULATION DEBRIEFING PRACTICES: THE SIMULATION DEBRIEFING STUDY Annette R. Waznonis, PhD, RN Saint Louis University School of Nursing
ANCC Continuing Nursing Education INACSL is an accredited ANCC provider.
DISCLOSURES Conflict of Interest Annette R. Waznonis (Primary Investigator) reports no conflict of interest Julia Greenawalt (INACSL Conference Administrator & Nurse Planner) reports no conflict of interest Leann Horsley (INACSL Lead Nurse Planner) reports no conflict of interest Successful Completion Attend 90% of session Complete online evaluation
OBJECTIVES Upon completion of this presentation, participants will be able to: 1. Describe three themes that reflect faculty experiences of using debriefing in simulation. 1. Identify two recommendations that will advance the science and practice of simulation debriefing.
ACKNOWLEDGMENTS Doctoral Dissertation Committee External Advisor/Mentor and Expert Consultants Marion Bender Scholarship National League for Nursing Potter Scholarship Delta Lambda Chapter Sigma Theta Tau International INACSL
BACKGROUND Simulation debriefing incorporates both feedback and reflection, with the goal of improving future practice (Meakim et al., 2013). Debriefing is a necessary component for learning to occur from simulation (Shinnick, Woo, Horwich, & Steadman, 2011). Expert opinions on effective simulation debriefing practices (SDP) are widely published, but research is minimal, with weak methodological designs and poor reporting of debriefing characteristics (Levett-Jones & Lapkin, 2014; Raemer et al., 2011). Use of a structured framework and evaluation of simulation debriefing are lacking in nursing education (Fey, 2014; Waznonis, 2015).
TERMINOLOGY Elements Method (aka of model, Debriefing framework) = the name or general description 1. of the Length debriefing of time process for the debriefing 2. Timing of debriefing in relation to simulation 3. Phases Physical (aka sections, environment parts, components, steps) = each step or part 4. of the Atmosphere debriefing method 5. Faculty experience 6. Faculty role 7. Approaches Student (aka roletechniques, strategies, styles) = what is used and 8. how Objectives it is used during of the the debriefing; alone or in combo within the 9. phases Methods of any method 10. Phases 11. Approaches 12. Elements Means (aka for characteristics, evaluation features, considerations) = the 13. contextual Challenges variables that experts believe influence the effectiveness of the debriefing process (Waznonis, 2014)
STUDY DESIGN Large-scale mixed methods study conducted to describe SDP of faculty in accredited, traditional, baccalaureate in nursing degree (BSN) programs in the United States Background and survey findings reported elsewhere (Waznonis, 2014; 2015) Purpose of interviews = to identify and describe faculty experiences of using debriefing in simulation with traditional BSN students and to explore faculty perceptions of the effectiveness of their SDP
STUDY DESIGN Recruitment Process One particular survey question What specific methods/models do you use to facilitate debriefing? Qualitative description design (Sandelowski, 2000; 2010) Identified two groups of faculty: Reported using a specific method of debriefing Did not report using a specific method of debriefing Semi-structured, individual phone interviews via Skype TM End of survey contact information provided First 10 faculty from each group who agreed to interview were chosen Purposive to participate sampling
STUDY TOOLS Interview demographic form Interview guide: 11 main questions with probes 60-minute interviews via Skype TM Interviews audio-recorded using Audio Hijack Pro (Rogue Amoeba Software, Inc., 2013) and back-up digital recorder Unstructured field notes Thematic analysis with help of Dedoose [web application] (Sociocultural Research Consultants, LLC, 2015)
DATA ANALYSIS Verified transcripts for accuracy Multiple readings of transcripts, field notes, interview abstracts, reflective notes, and analysis journals Member checking (Braun & Clark, 2006) Open coding to identify semantic themes
FINDINGS Participant characteristics (n=23) 17 states represented Three 100% Themes (n=23/23) Emerged full-time 82% (n=18/23) university/college setting 61% Having (n=14/23) the students urban best interest at heart Mean (M) = 55 years of age 91% Getting (n=21/23) over female the emotional hurdle 57% (n=13/23) master s degree; 39% (n=9/23) doctoral M = Intentional 27 years of debriefing clinical practice evolves experience into learning M = 12 years of teaching experience M= 6 years of teaching in simulation (mode = 7) M= 6 years using debriefing in simulation (mode = 2)
THEME 1 Having the Students Best Interest at Heart Sub-themes Knowing each other establishes trust Prebriefing focuses the debriefing on objectives A safe learning environment is comfortable
THEME 2 Getting Over the Emotional Hurdle Sub-themes Students start the debriefing Paying attention to emotions Keeping it positive
THEME 2 Evolves into Intentional Debriefing Learning Sub-themes Meeting the students where they are Getting everyone to participate to broaden the learning Watching the clock Faculty learning from debriefing
DISCUSSION INACSL Study Standard Limitations for Simulation Debriefing Criterion 1: Faculty Competency May Criterion not represent 2: Environment entire target population Time Criterion lapse, but 3: not Facilitator longitudinal Responsibilities Use of technology may have deterred Criterion 4: Structured Framework participation Criterion 5: Objectives and Outcomes
IMPLICATIONS Use of Consistent Language Time Faculty Development Future Research
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CONTACTS E-mail: annette.waznonis@gmail.com