Debriefing is a reflective discussion led by a facilitator using guided prompts to cognitively process practice experiences and gain a greater understanding of the experience and the decisions made (Fanning & Gaba, 2007; Fey & Jenkins, 2015; INACSL, 2016). Debriefing promotes active learning and assists students in the attainment of new knowledge, skills, and attitudes in the clinical learning environment (Fey & Jenkins, 2015; National League of Nursing [NLN], 2015; Shinnick, Woo, Horwich, & Steadman, 2011). While frequently used in conjunction with simulation learning, debriefing methods may also be paired with case-based scenarios in the classroom to connect class content to the clinical setting.
Case-based scenarios provide background information about a client and a clinical scenario followed by a series of related questions. Students complete the questions followed by an open discussion about the scenario. This discussion allows students time for reflection on the case, actions, and alternative approaches; it also provides time for nurse educators to ask questions, observe student behaviors, and examine students’ understanding and application of the nursing process (Oermann & Gaberson, 2017). Both reflection-in-action and reflection-on-action take place while students think about interventions and evaluate possible outcomes (Dreifuerst, 2015; Schön, 1983).
Case-based scenarios and the questioning that follows are techniques used to implement Debriefing for Meaningful Learning© (DML). DML incorporates constructivist and problem-based learning theories as well as reflection-in-action and reflection-on-action (Dreifuerst, 2015; Schön, 1983). To use DML, the case-based scenario must have a client name and story. The nurse educator guides student participation through six phases of the DML process that include: engage, explore, explain, elaborate, evaluate, and extend. This process encourages active participation by all students to explore actions taken, decisions made, and application of the case-based scenario for the future.
To better understand the connection between classroom debriefing and student reflection, a study was conducted to examine how participation in classroom debriefing sessions (using the Debriefing for Meaningful Learning© [DML] method) influenced nursing students’ perceptions of their self-reflective abilities over time. A quantitative one-group, pretest—posttest design was used prior to and following student participation in six weeks of classroom debriefing. The Groningen Reflection Ability Scale (GRAS) was used to assess students’ perceptions of self-reflective ability. The sample included sophomore-level, pre-licensure baccalaureate students at a large state university. Findings revealed significant improvement in students’ perceptions of self-reflective ability following six weeks of classroom debriefing sessions t(101) = 5.08, p < .0005.
The results of this study offer insight to nurse educators on pre-licensure baccalaureate nursing students’ reflective abilities. Implications of this study provide a starting point for educators to plan and implement debriefing across the nursing curriculum. Nurse educators play a crucial role in facilitating the DML process and developing students’ reflective skills. Acquisition of reflective skills at the baccalaureate level will assist students in transitioning to the role of reflective practitioner in the complex, changing healthcare environment (AACN, 2008).