Debriefing Practices in Nursing Education Programs in the United States

Abstract

Debriefing is essential to learning in simulation based education. However, little is known about current debriefing practices. While there is no single theory of debriefing, consistent themes about the characteristics of debriefing emerge from the simulation literature. The purpose of this study was to describe debriefing practices in prelicensure nursing programs. Logistic regression analysis identified the characteristics of the nursing program and the simulation administrator that are associated with the use of theory based debriefing. A descriptive cross-sectional design was used. Data was collected via the internet. The study questionnaire consisted of three parts: demographic questions about the nursing program, questions about the simulation administrator, and questions about debriefing practices. The study sample comprised prelicensure nursing programs from across the United States representing all entry level degree programs (n = 502). Descriptive analyses showed that most programs have integrated simulation into their curriculum. Most schools designate a faculty member to have responsibility for simulation activities. The majority of debriefing facilitators have no training in debriefing. Less than 20% of all debriefers have their competence assessed. Debriefing is not usually guided by a theory or model. The majority of respondents (82%) reported debriefing practices that incorporated the concepts of Kolb's experiential learning theory. Further data analysis explored the relationships that significantly affected the use of theory based debriefing practices. The presence of a designated simulation administrator was significantly associated with the use of theory based debriefing. Simulation administrators who had formal training in simulation and who were in the 46-55 year old age group were significantly more likely to practice theory based debriefing. Training and competency assessment, along with structuring debriefing discussions were significantly associated with the use of theory based debriefing. Findings suggest that nursing programs should allocated resources to several aspects of the simulation program. Programs should have a designated simulation administrator. This person should have training in simulation based education. All faculty who facilitate debriefings should have training and should have their competence assessed regularly. This study provides information about debriefing practices; the study should be repeated with other types of learners (e.g. medical students, licensed practitioners).