RESUMO
BACKGROUND: As an integral part of simulation, debriefing helps learners to construct knowledge through reflecting, internalizing, and relating. Video-assisted debriefing (VAD) adds audio-visual captures and reviews to support traditional verbal debriefing (VD), but evidence evaluating its educational effects has been mixed, with limited attention focusing on its structure development. AIMS: This study aimed to 1) investigate the effects of a three-phase VAD in enhancing nursing students' debriefing experiences and perceived stress compared to VD and 2) to explore its impact on facilitators' debriefing practices. METHODS: A mixed-methods design was adopted. The quantitative phase involved a prospective controlled trial on 145 nursing students from a university in Singapore who were randomized into the intervention cluster (n = 72) and the control cluster (n = 73). The debriefing experience scale (DES), the stress visual analogue scale (Stress VAS), and the debriefing assessment for simulation in healthcare (DASH© student version) were used as outcome measures. For the qualitative component, a purposive sample of eight facilitators evaluated their own debriefing practices using the DASH© instructor version and each completed an open-ended question survey. Qualitative data were analyzed using content analysis. RESULTS: Students from the intervention cluster significantly improved their debriefing experiences (p = 0.01), experienced comparable stress, and had better impressions of VAD facilitators' practices (p < 0.001) compared to those in the control cluster. Repeated VAD significantly reduced students' stress (p < 0.001). Students viewed the VAD facilitators as more effective than the VD facilitators. Three categories were derived from the qualitative comments: the act of debriefing, the crux of VAD, and debriefing for success. CONCLUSION: The three-phase VAD significantly improved nursing students' debriefing experiences without adding extra stress. It also helped to improve facilitators' practices. Future research will benefit from exploring how experts facilitate the three-phase VAD "on the ground" and its effect on learning transfer and cost-effectiveness.
RESUMO
BACKGROUND: Video-assisted debriefing has not attracted sufficient attention on exploring learners' perceptions. A full understanding of learners' attitudes and perceptions towards video-assisted debriefing sets the foundation for effective learning, which should be considered when integrating video-assisted debriefing to the nursing curricula. However, limited evidence on learners' perspectives makes it difficult to fully understand this phenomenon. OBJECTIVES: To explore prelicensure nursing students' experiences and perspectives on video-assisted debriefing following a high-fidelity simulation. DESIGN: An exploratory qualitative approach using focus groups. SETTING: This study was conducted at a local university in Singapore. PARTICIPANTS: A purposive sample of 27 prelicensure nursing students in Singapore were recruited. METHODS: Six focus group interviews were conducted. Thematic analysis was used to analyze the transcribed data. RESULTS: Three themes and eight subthemes were derived from the data analysis. The themes included journey from traditional verbal debriefing to video-assisted debriefing, praise and criticism of video-assisted debriefing, and the road to successful video-assisted debriefing. CONCLUSIONS: Nursing students revealed that video-assisted debriefing not only complemented the drawback of verbal debriefing by offering objective evidence but also improved their attitudes and behaviors through the unique experience of an emotional roller coaster. Learners should be desensitized to the fear of video and their discriminating capabilities should be developed prior to video-assisted debriefing. The findings can serve as a reference when designing and integrating video-assisted debriefing interventions into simulation-based education.
