Debriefing evaluation in nursing clinical simulation: a cross-sectional study

Quantitative study, conducted with 35 nursing students who participated in five clinical simulation scenarios with planned debriefings based on the model of the National League Nursing/Jeffries Simulation Theory. After the fifth scenario, students answered the Debriefing Evaluation Scale associated with the Simulation.

Results:

The items evaluated involved the psychosocial, cognitive, and affective values, and within a scale from one to five, the highest mean was found in cognitive value with 4.23 (±0.56) points, then in psychosocial value with 3.77 (±0.53), and finally in affective value with 3.71 (±0.63) points.

Conclusion:

The debriefing conducted after the clinical simulation scenarios was a reflective exercise that contributed to the student integrating multiple knowledges in affective, cognitive and psychosocial values, and thus develop the competencies required.

Descriptors:
Simulation; Thinking; Clinical Competence; Learning; Nursing Students

Scenarios^* * The total of 35 students participated in all scenarios. During the second semester of 2015, the 20 students were divided into four teams of five participants. In the first semester of 2016, the 15 students were divided into three teams of five participants.	Objectives
	Non-technical skills	Technical skills
Stroke	Know the environment; anticipate and plan; designate leadership; distribute the workload; communicate effectively.	Perform directed neurological evaluation; assess vital signs and plan carefully; determine heart rate and associate it to the etiology of sloping rima oris; observe signs and symptoms and intervene; administer medications according to protocol.
Congestive heart failure with arrhythmias	Designate leadership; distribute the workload and communicate effectively.	Assess vital signs and intervene; conduct targeted physical examination and intervene; request additional tests, if necessary; determine heart rate; administer medication according to medical prescription.
Basic life support	Designate leadership; distribute the workload; anticipate and plan; communicate effectively; mobilize resources.	Perform basic life support care according to the American Heart Association protocol.
Advanced life support I	Designate leadership and promote team work; distribute the workload with well-defined functions; anticipate and plan; mobilize resources; communicate in closed loop; adopt clear and targeted messages.	Perform advanced life support care according to the American Heart Association protocol.
Advanced life support II	Designate leadership and promote team work; distribute the workload with well-defined functions; anticipate and plan; mobilize resources; communicate in closed loop and adopt clear and targeted messages; share knowledge; perform constructive intervention; know own limitations.	Perform ALS service according to American Heart Association protocol; start care upon return of spontaneous circulation and reassess service.

DIMENSIONS	MIN^* * Minimum;	MAX^† † Maximum;	M^± ± Mean;	SD^§ § Standard Deviation
Factor 1 - Psychosocial value	2,2	5,0	3,77	,56
Factor 2 - Cognitive value	2,6	5,0	4,23	,53
Factor 3 - Affective value	2,5	5,0	3,71	,63

Dimension	ITENS	Completely disagree		Disagree		Indifferent		Agree		Completely agree
Dimension	ITENS	N	%	N	%	N	%	N	%	N	%
Psychosocial Value	16 Increase my self-confidence					12	34.3	14	40	9	25.7
	17 Develop leadership competencies			1	2.9	4	11.4	21	60	9	25.7
	19 Increase the potential for teamwork			1	2.9	3	8.6	18	51.4	13	37.1
	21 Feel accomplished	1	2.9	3	8.6	23	65.7	4	11.4	4	11.4
	22 Reinforce my initiative in future situations			1	2.9	6	17.1	17	48.6	11	31.4
	23 Develop the care relationship	2	5.7			3	8.6	18	51.4	12	34.3
	25 Reinforce my autonomy to act as a future nurse					7	20	17	48.6	11	31.4
	26 Trace difficulties in my performance	1	2.9			4	11.4	21	60	9	25.7
	27 Promote self-awareness (know one's own emotions)					4	11.4	18	51.4	13	37.2
	28 Feel in the center of the educational process	2	5.7	7	20	7	20	14	40	5	14.3
	30 Improve my ability to manage emotions			1	2.9	5	14.3	21	60	8	22.8
	32 Feel proud for being able to execute many interventions correctly			2	5.7	8	22.9	22	62.8	3	8.6
	33 Feel that the professor has genuine interest in my professional development	1	2.9	2	5.7	8	22.9	16	45.6	8	22.9
Cognitive value	1 Structure my thought			1	2.9	5	14.3	17	48.6	12	34.2
	3 Learn more			1	2.9			21	60	13	37.1
	4 Focus on the important aspects of performance					5	14.3	18	51.4	12	34.3
	6 Reflect on my competencies					1	2.9	24	68.5	10	28.6
	7 Determine priorities in the practice					1	2.9	17	48.6	17	48.5
	8 Better determine the resources to use in the practice			1	2.9	4	11	19	53	11	33.1
	10 Deepen specific knowledge related to the practice			1	2.9	4	11.4	17	48.6	13	37.1
	12 Trace aspects that I should improve in future practice			1	2.9	2	5.7	19	54.3	13	37.1
	13 Develop skills for making good decisions			1	2.9	2	5.7	21	60	11	31.4
Affective value	2 Feel ashamed in front of colleagues for my mistakes	10	28.5	11	31.4	8	22.9	5	14.3	1	2.9
	5 Make me very anxious/stressed out	4	11	12	34.3	9	25.7	7	20.4	3	8.6
	9 Feel humiliated in front of others	12	34.3	14	40	8	22.8	1	2.9
	11 Be in panic at the thought of having to act again in a similar situation	10	28.6	13	37.1	9	25.7	2	5.7	1	2.9
	14 Create conflicts in the group	8	22.8	19	54.3	1	2.9	3	8.6	4	11.4
	15 Not want to participate in any simulation	8	22.8	15	42.9	9	25.7	2	5.7	1	2.9
	18 Feel misunderstood	9	25.7	21	60	4	11.4	1	2.9
	20 Feel disrespected	15	42.8	13	40	5	14.3	1	2.9
	24 I feel it was a waste of time	11	31.5	16	45.7	6	17.1			2	5.7
	29 Be afraid to act in similar situations in the future	10	28.6	17	48.5	5	14.3	2	5.7	1	2.9
	31 Block my reasoning	10	28.6	16	45.7	7	20	2	5.7
	34 Scramble my ideas about the practice	13	37.1	10	28.6	9	25.7	2	5.7	1	2.9

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[1] Corresponding Author: Carina Bortolato-Major. E-mail: cabortolato@uenp.edu.br