Too Anxious To Learn? Should the Ongoing Debriefing Technique be Amongst the Best Practices in Simulation?

Abstract

Aim: The aim of this capstone project was to demonstrate benefit of the Ongoing Simulation Debriefing Technique on lowering anxiety levels amongst those participating in simulation activities. Ongoing Simulation Debriefing Technique is a method by which simulation participants, who are viewing simulations, are guided by a knowledgeable debriefer while the simulation is occurring. Introduction: It has been established that moderate levels of stress are necessary for effective learning. In contrast, excessive stress and anxiety can not only impair but hinder psychomotor performance. There is scientific evidence that a relationship exists between high levels of stress in simulation and poor performance. However, the degree of stress and effects on learning and performance produced by simulation in Certified Registered Nurse Anesthetist (CRNA) training programs are unknown. In addition, it is unknown if these effects might affect their behaviors in future clinical settings. Method: After IRB approval, the pre-simulation/post-simulation anxiety levels were evaluated in first year nurse anesthesia students (n=26) in three different scenarios using State Trait Anxiety Inventory (STAI). Students were divided into two groups - Control group (End Debriefing) and Experimental group (Ongoing Simulation Debriefing Technique). Both groups were exposed to identical simulations of increasing scenario complexity with the last scenario being the most difficult and complex (pediatric induction). The data were collected from 2012 to 2013. Results: A quasi-experimental design was used to collect research data and analyzed for validity and significance utilizing SPSS and T-test analysis. The anxiety levels were reduced in both control and experimental groups post simulation as compared to their pre simulation values as evident by STAI scores. The overall mean STAI scores were reduced by 15.21 and 21.81 percentage points, respectively, in control and experimental groups. The difference between means was statistically significant (P < 0.001). Conclusion: Ongoing Simulation Debriefing Technique reduces stress and anxiety levels generated by simulation more than when using the End-Debriefing Technique. The Ongoing Simulation Debriefing Technique creates a safer learning environment in which students can maximize their learning potential. This technique should be considered as a best practice for Simulation Based Learning with adults. This method has shown to exhibit more confidence in students but more research is needed to determine its implications on performance in the clinical setting