The impact of a three-phase video-assisted debriefing on nursing students' debriefing experiences, perceived stress and facilitators' practices: A mixed methods study

Abstract

BackgroundAs an integral part of simulation, debriefing helps learners to construct knowledge through reflecting, internalizing, and relating. Video-assisted debriefing (VAD) adds audio-visual captures and reviews to support traditional verbal debriefing (VD), but evidence evaluating its educational effects has been mixed, with limited attention focusing on its structure development. AimsThis study aimed to 1) investigate the effects of a three-phase VAD in enhancing nursing students' debriefing experiences and perceived stress compared to VD and 2) to explore its impact on facilitators' debriefing practices. MethodsA mixed-methods design was adopted. The quantitative phase involved a prospective controlled trial on 145 nursing students from a university in Singapore who were randomized into the intervention cluster (n = 72) and the control cluster (n = 73). The debriefing experience scale (DES), the stress visual analogue scale (Stress VAS), and the debriefing assessment for simulation in healthcare (DASH© student version) were used as outcome measures. For the qualitative component, a purposive sample of eight facilitators evaluated their own debriefing practices using the DASH© instructor version and each completed an open-ended question survey. Qualitative data were analyzed using content analysis. ResultsStudents from the intervention cluster significantly improved their debriefing experiences (p = 0.01), experienced comparable stress, and had better impressions of VAD facilitators' practices (p < 0.001) compared to those in the control cluster. Repeated VAD significantly reduced students' stress (p < 0.001). Students viewed the VAD facilitators as more effective than the VD facilitators. Three categories were derived from the qualitative comments: the act of debriefing, the crux of VAD, and debriefing for success. ConclusionThe three-phase VAD significantly improved nursing students' debriefing experiences without adding extra stress. It also helped to improve facilitators' practices. Future research will benefit from exploring how experts facilitate the three-phase VAD “on the ground” and its effect on learning transfer and cost-effectiveness.