A Comparison of the Impact of Debriefing Methods on Clinical Judgment

Abstract

With the ever-increasing complexity of patient conditions and comorbidities, it is critical that nurses develop and incorporate clinical judgment into practice. The structured debriefing process as part of simulation supports reflection by learners so they can apply the knowledge obtained during the simulation in the development of clinical judgment to future clinical practice. There is a gap in the literature as to the best way to conduct the structured debrief in order to promote clinical judgment. The project used an experimental research design to compare the effect of two different simulation debriefing techniques on clinical judgment in newly licensed registered nurses: debriefing after a simulation-based experience compared to in-simulation debriefing. A post-intervention assessment took place measuring the change in the nurses’ subjective rating of their clinical judgment 10 to 14 days after the simulation to allow the learner to reflect on the simulation experience and implement the knowledge attained into practice. A convenience sample was obtained from the accessible population for the study, which consists of approximately 250 newly licensed registered nurses on adult cardiac step-down, cardiac critical care, cardiac acute care, or cardiac accelerated recovery care setting. The calculated sample size for the study was 62 participants. Adequate sample size was unable to be obtained. A Mann-Whitney U Test revealed no difference in total LCJR scores between post event debrief (Md = 35.5, n = 4) and in-simulation debrief (Md = 34, n = 3), U = 9.5, z = 1.26, p = .23, r = .5. There was not a difference between debriefing methods. The study should continue until the predicted sample size (N = 62) is obtained to determine if there is statistical significance.