Stress, Performance, and Video-Assisted Debriefing

Monday, 30 October 2017

Marycarol Rossignol, PhD
Henry P. Becton School of Nursing and Allied Health, Fairleigh Dickinson University, Florham Park, NJ, USA


Simulation instructors strive to create a learning environment that closely represents reality because recreating realistic health care situations can more substantially promote encoding and learning that prompts the acquisition of clinical knowledge and skills. Experts frequently recommend use of video playback during debriefing in order to add to learning, however, it is unclear if the incorporation of video review in the facilitated debriefing session increases stress and inhibits performance of trainees.


An overview of the theoretical and research literature in simulation with a focus on stress, performance and debriefing practices will be presented. Recommended features and types of debriefings held after simulation exercises will be reviewed. In particular, benefits and barriers of video-assisted debriefing will be discussed along with identification of outcomes that have been studied. Research findings will be described that measured stress responses and performance of nursing students in a repeat simulation and compared effects of two types of debriefing (Rossignol, in press, “Effects of Video-Assisted Debriefing”). In addition, implications of the published research such as what faculty can do to optimize the learning conditions of simulation experiences will be explored.


Simulation experiences can be more stressful than actual clinical experiences with real patients (Judd et al., 2016). The conditions that may elevate stress and anxiety of learners in the simulation laboratory will be described. Research has demonstrated evidence in support of the effectiveness of debriefing, compared to no debriefing (Hamad, Brown, & Clavijo-Alvarez, 2007), whereas the question whether there is added or meaningful benefits with video review remains unclear (Cheng et al., 2014). Findings from a randomized controlled trial of facilitator-led debriefing groups: with and without video review, suggested that the video recording of simulations did not elevate anxiety or lower performance of participants (Rossignol, in press, “Effects of Video-Assisted Debriefing”).


Video recording of simulation performances did not negatively impact learning conditions. Students benefit from simulation-based learning opportunites that involve motivated performances and feedback in debriefings. Facilitator-led debriefings, with or without video, can shape future performance.