Debriefing Styles and Clinical Judgment in Nursing Students

Официальное название

The Influence of Instructor-centered Versus Learner-centered Debriefing on Clinical Judgment in Nursing Students: A Mixed-methods Experimental Study Protocol.

Обзор

Simulation is a cornerstone of health sciences education, with debriefing being its most critical component for fostering clinical skills. While various debriefing styles exist, there is limited evidence comparing the effectiveness of instructor-centered (ICT) versus learner-centered (LCT) approaches, specifically on the development of clinical judgment in nursing students.

Подробное описание

Several studies suggest a general preference for a Learner-Centered (LCT) style during simulation debriefing. However, existing literature and expert opinion often recommend an Instructor-Centered (ICT) style for novice learners or in time-limited situations. It is critical to note that these recommendations are not consistently based on robust scientific evidence, highlighting a significant gap in nursing education research. This study is designed to address this gap by systematically evaluating the impact of ICT versus LCT debriefing on the acquisition of clinical judgment in undergraduate nursing students-a cornerstone competency for professional practice.

The study's central hypothesis is: "The debriefing style, whether instructor-centered (ICT) or learner-centered (LCT), differently impacts students' learning process in clinical judgment."

To test this hypothesis, the study employs a mixed-methods sequential explanatory design. The initial quantitative phase consists of a randomized controlled trial to determine the effect of the two debriefing styles. This will be followed by a qualitative phase, utilizing focus groups, to explore the students' perceptions and experiences, thereby providing a deeper, contextual explanation for the quantitative findings.

To ensure the integrity of the intervention, methodological fidelity will be rigorously monitored. The distinction between the ICT and LCT styles will be verified through objective measures, including the analysis of faculty-to-student talk-time ratios and the mapping of conversation patterns (sociograms) during debriefing sessions. This ensures that the observed differences in learning can be confidently attributed to the assigned debriefing style. The integration of both quantitative and qualitative data will yield a comprehensive understanding of how different pedagogical approaches in simulation debriefing influence the complex process of clinical judgment development.

Вмешательства

• Поведенческое Learner-Centered Debriefing
  Two 2-hour simulation sessions followed by a learner-centered debriefing conducted by a trained facilitator. This style emphasizes guided reflection and co-construction of knowledge.
• Поведенческое Instructor-Centered Debriefing
  Two 2-hour simulation sessions followed by an instructor-centered debriefing conducted by a trained facilitator. This style is the standard practice at the institution and focuses on direct feedback and information transfer from the instructor.

Первичные конечные точки

• Change in Clinical Judgment Assessed by the Lasater Clinical Judgment Rubric (LCJR) [Срок оценки: Assessed at two time points: at Baseline (measurement taken during the first-term practical exam, prior to the intervention) and Post-Intervention (measurement taken during the final practical exam, approximately 3 months after the baseline assessment).]

Вторичные конечные точки (1)

• Student Perceptions of the Learning Experience Assessed by Focus Group Topic Guide [Срок оценки: Up to 3 weeks after the final simulation session.]

Критерии участия

Критерии включения

-Students enrolled in the Basic Simulation Labs 2 (LBS2) course as part of their program.

Критерии исключения

• Students who cannot participate in all phases of the study.
• Students who do not provide informed consent.
• Students who are repeating the course.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Другое

Центры проведения

Испания · 1 центр

• International University of Catalonia — Sant Cugat del Vallès

Публикации

• Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015 Apr;10(2):106-15. doi: 10.1097/SIH.0000000000000072. PMID 25710312
• Roman-Cereto M, Garcia-Mayor S, Kaknani-Uttumchandani S, Garcia-Gamez M, Leon-Campos A, Fernandez-Ordonez E, Ruiz-Garcia ML, Marti-Garcia C, Lopez-Leiva I, Lasater K, Morales-Asencio JM. Cultural adaptation and validation of the Lasater Clinical Judgment Rubric in nursing students in Spain. Nurse Educ Today. 2018 May;64:71-78. doi: 10.1016/j.nedt.2018.02.002. Epub 2018 Feb 9. PMID 29459195
• Cheng A, Morse KJ, Rudolph J, Arab AA, Runnacles J, Eppich W. Learner-Centered Debriefing for Health Care Simulation Education: Lessons for Faculty Development. Simul Healthc. 2016 Feb;11(1):32-40. doi: 10.1097/SIH.0000000000000136. PMID 26836466

Идентификаторы

NCT: NCT07262424 · LCTandICTDebriefing&ClinJudge

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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