How nursing students learn to care for deteriorating patients in debriefing: A mixed-methods study

Abstract

<p>Previous studies on debriefing have addressed components such as video assistance, duration, content, or educator presence and characteristics (Cheng et al., 2014). However, studies of how nursing students learn in debriefing remain scarce, even if Cook and al. (2008) recommended that educational research addresses processes underpinning learning outcomes. In the first phase of a mixed-methods study, students (n=117) participated in a randomized controlled trial comparing the effect of two debriefing methods after patient deterioration simulations: a reflective debriefing for clinical judgment (REsPoND; Lavoie, Pepin, &amp; Cossette, 2015) or the Plus-delta debriefing technique (Fanning &amp; Gaba, 2007). REsPoND consists in a reflective analysis of a patient deterioration simulation experience through a list of questions designed after Tanner&rsquo;s (2006) model of clinical judgment and Dewey&rsquo;s (1907) conception of reflection. Based on the results of the RCT, we interviewed nineteen nursing students who experienced REsPoND to study their perception of how they learned in this debriefing. Thematic analysis of the transcripts revealed that students&rsquo; perceived that they learned through a process of describing and analyzing a situation to build a framework of how they should have responded to the simulated patient deterioration situation. Then, they compare their performance to that framework in order to target good behaviors and those that need improvement. The characteristics and interactions of the debriefer and the students (as a group) appear as influential on this process. Variations in students&rsquo; perceptions of this process according to their results in the RCT will be presented and discussed.</p>