Within prelicensure nursing education at the diploma, associate, and baccalaureate levels, there has been an increased emphasis on the ability of nurse educators to facilitate the development of clinical judgment within nursing students using constructivist teaching methods (Weaver, 2014). This increased emphasis on constructivist teaching and clinical judgment development has been coupled with diminishing availability of clinical sites and increasingly advanced simulation technologies, thus leading to an increased focus on simulation-based learning (SBL). The importance of SBL was further evaluated in the landmark study conducted by nurse researchers at the National Council for State Boards of Nursing (NCSBN), which suggested that SBL could be used as an effective replacement for clinical hours in prelicensure nursing programs when performed under specific conditions, with one such condition being the use of structured debriefing (Hayden, Smiley, Alexander, Kardong-Edgren, & Jeffries, 2014). According to Wittman-Price, Godshall, and Wilson (2017), the debriefing portion of SBL is crucial to the development of higher-level thinking skills and, for this reason, faculty members involved in SBL should have adequate preparation on conducting debriefing sessions. Furthermore, the leaders of the International Nursing Association for Clinical Simulation and Learning (2016) have included the use of structured debriefing as one of the organization’s best practice standards. Yet, the use of structured debriefing by nursing faculty members is inconsistently applied. As a result, the effectiveness of SBL in developing clinical judgment may also be inconsistent.
Methods:
An evidence-synthesizing project was conducted with the purpose of evaluating the effect of structured debriefing on clinical judgment development among prelicensure nursing students. One reviewer conducted a literature search using CINAHL, PubMed, and Medline. Although seminal works were used as references, only original pieces of evidence from peer-reviewed journals published within the last seven years were included for review. A poster presentation was created in order to disseminate the information gained from the evidence-synthesizing project. The learning objective of the poster presentation is that, after reviewing the information included within the poster, the learners will be able to discuss the relationship between structured debriefing and clinical judgment development in SBL.
Results:
Within the 10 studies selected for review, researchers consistently noted that the use of structured debriefing within SBL activities positively impacted clinical judgment; however, the statistical significance of these positive changes in clinical judgment abilities of prelicensure nursing students was inconsistent. Additionally, three themes emerged, which are as follows: the ability to “think like a nurse,” safety, and confidence. Strengths of this evidence-synthesizing project were that the pieces of evidence reviewed included research and non-research evidence published within the last seven years. Limitations included inconsistencies in the structured debriefing tools used and the evaluation tools used to measure clinical judgment.
Conclusion:
Further research using a consistent structured debriefing method and clinical judgment evaluation tool is indicated. However, it is recommended that nursing faculty members be equipped with educational preparation to use structured debriefing tools and that structured debriefing be implemented within SBL activities as the use of structured debriefing within SBL positively impacts clinical judgment development.