The impact of debriefing modalities on nurse practitioner students' knowledge and leadership skills in managing fatal dysrhythmias: A pilot study.

Acute care nurse practitioners (ACNPs) require special training and educational preparation to meet their role expectations. Using high fidelity simulation with debriefing modalities is considered one of the innovative learning strategies in graduate nursing. No studies have investigated debriefing modalities in nurse practitioner programs specially ACNPs leadership skills. The purpose of this study was to examine the difference in students' knowledge, code team leader skills and self-efficacy using two debriefing modalities. A two group, pretest-posttest quasi-experimental design was used. Students were divided into video-assisted debriefing group vs. verbal debriefing following a simulation scenario of managing emergency codes. There were no significant differences between the two groups in knowledge acquisition/retention, leadership skills, and self-efficacy, but there was a significant difference in self-efficacy in both groups between two-time points. There was a general improvement in teams' performance. Students preferred verbal debriefing over video-assisted debriefing. The debriefing session plays an important role in graduate nursing education. Acute care nurse practitioners are lacking a formal leadership training to meet their advanced role. Nurse Educators, and simulation/debriefing leaders may benefit from our study results to develop a structured, formal curriculum and educational instruction focusing on acute care nurse practitioners' role change especially leading a resuscitation team.

Using Simulation to Assess the Impact of Triage Interruptions.

INTRODUCTION: Interruptions are common in the emergency department and contribute to catastrophic errors. Care priorities and acuity levels are assigned during triage, meaning that mistakes and omissions during the triage process could have detrimental effects on patients. The purpose of this project was to assess the feasibility of investigating the impact of interruptions on triage and the decision-making process in a simulated setting. METHODS: A 2-phase, sequential exploratory mixed method design was used. Nine nurses from 3 emergency departments in a Midwest area participated. A short demographic questionnaire was used to collect information about the nurses' education and experience. The Emergency Severity Index (ESI) was used for triage categorization. Each participant completed 2 scenarios (one interrupted and one uninterrupted). After completion of the scenarios, video-simulated recall interviews were used to assess the simulation experience and the impact that interruptions had on the triage decision-making process. RESULTS: Triage time had a mean of 10 minutes and ranged between 4.34 minutes and 13.45 minutes. However, triage was significantly longer during the interrupted scenarios. Seventy-seven percent of the acuity assessments (ESI) were correct. Of the 18 scenarios, 3 uninterrupted scenarios had incorrect ESI scores, and one interrupted scenario had a missing acuity score. DISCUSSION: This study provides the basis for future work that looks at how nurses successfully manage interruptions and tests interventions to assist triage nurses in managing or reducing interruptions during this important patient assessment process.