Exploring an Adaptive Version of the 3D Model of Debriefing Using a Virtual Patient Simulation

Saturday, March 28, 2020: 11:35 AM

Francisco A. Jimenez, PhD, MA
Cheryl Wilson, DNP, APRN, ANP-BC, FNP-BC,CNE
Shadow Health, Inc, Gainesville, FL, USA

Purpose:

Debriefing is one of the most fundamental components of any simulation learning experience in nursing (Chronister & Brown, 2012; Dreifuerst, 2009; INACSL Standards Committee, 2016; Meakim et al., 2013; Verkuyl et al., 2017). Virtual patient simulations provide a unique opportunity for experiential learning if debriefed efficiently because they allow students to explore different clinical situations and make complex decisions in a safe environment (Gordon, 2017; Verkuyl et al., 2018a, 2018b). In this experimental study, we explored the debriefing experience of students using the 3D Model of Debriefing (Zigmont et al., 2011) after completing a virtual patient simulation module on conflict management.

Methods:

Participants: The virtual patient simulation on conflict management scenario was completed by 44 students enrolled in a traditional four-year BSN program from a public university located in the southeast of the United States.

Simulation Scenario: In the simulation, the student takes on the role of a nurse at a hospital’s medical-surgical unit and faces challenges in the form of patient and workplace conflict. Throughout the simulation, the student must identify and use appropriate conflict management strategies to ensure positive outcomes for patient care. Upon completing the scenario, the student reflects on the experience by responding to a series of reflection prompts based on the 3D Model guided by a virtual preceptor (i.e., defusing, discovering, and deepening). The debrief prompts adapt based on student performance in critical decision points during the simulation. Students review these decision points in context and then answer specific, structured debriefing questions about those decisions.

Data Analysis: Student responses were first coded for distinct themes. Then, responses were counted within each of the identified themes to obtain frequencies of occurrence.

Results:

Fifty six percent of the students reported having positive feelings about their performance in the simulation, while 44% expressed having neutral or mixed feelings about their performance. Students reporting positive feelings mentioned practicing prioritization and interprofessional communication, understanding the rationale behind wrong choices made, fostering open communication with family members, and the ability to manage conflict professionally as factors contributing to their positive experience. On the other hand, students reporting mixed or neutral feelings mentioned the difficulties associated to assuming the role of a charge nurse, prioritizing patients, and communicating with patients and family members as factors contributing to their more neutral experience. More data insights will be shared during the presentation.

Conclusion:

The results of this study suggest that students can experience the benefits of a transformative learning experience when they are debriefed using the 3D Model of Debriefing after completing a virtual patient simulation. Through transformative learning, the 3D Model facilitates the opportunity for students to reexamine their existing knowledge, assumptions, and biases. Likewise, students can extrapolate what was learned to other situations and think about how they would use it to guide their practice. The adaptive nature of the debrief used in this study also allowed students to reflect on those decisions and instances where patient-centered care leadership skills were needed to achieve the best patient care and outcomes.

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