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Introduction

“Without reflection, we go blindly on our way, creating more unintended consequences and failing to achieve anything useful.”

-Margaret J. Wheatley

OBJECTIVES

  • Understand the importance of the reflective practice of debriefing as a part of simulation.

  • Identify debriefing techniques that promote participant learning.

  • Differentiate among various debriefing methods, and identify situations in which each might be implemented.

  • Gain a basic understanding of available evaluation tools for debriefing.

Reflection is an important strategy for learning through practice experiences. Effective reflection to promote learning is a deliberate process of critically thinking about an experience, leading to insights about how to make future practice changes.

Reflection can (Miraglia & Asselin, 2015):

  • Enhance knowledge

  • Transform assumptions, values, and beliefs

  • Inform clinical practice

Reflection fosters self-dialogue about a situation and the emergence of new insights. Meaningful reflection enables a better look at oneself, allowing self-discovery and promoting critical and creative thinking. Through reflection, the intent to change practice develops. For healthcare providers, reflection also helps to maintain competence and keep abreast of current practices (Asselin, Schwartz-Barcott, & Osterman, 2013; Naicker & van Rensburg, 2018).

Reflection is an important part of Kolb's experiential learning theory (Kolb & Kolb, 2017). This theory places the learner, rather than the educator, in the center of the learning cycle. The cycle consists of four stages:

  • Concrete experience

  • Reflective observation

  • Abstract conceptualization

  • Active experimentation

Learners enter this cycle either where they are placed by outside processes—for example, by an educator—or where they are comfortable entering (Kolb & Kolb, 2005, 2017). Through reflection on their experiences, learners can reconcile what they view and think with what they have experienced (Wang, 2011).

The reflective period following a simulation-based experience is called debriefing. The purpose of a debriefing is to assimilate new learning, with the intent to transfer this learning to future clinical situations. During debriefing, reflective thinking is encouraged, and feedback is given on the simulation performance. Participants are encouraged to question, explore emotions, and give feedback to each other (International Nursing Association of Clinical Simulation and Learning [INACSL] Standards Committee, 2016c). Debriefing is also important in other areas of nursing education. It should be used throughout a nursing curriculum to help develop reflective practitioners, which may have a significant effect on learning outcomes (National League for Nursing, 2015).

Debriefing should be a part of every simulation-based experience because learning depends on incorporating what is learned in simulation with prior knowledge. The reflection provided through a debriefing should focus on best practices to promote safe, quality patient care and also to promote the participant's professional role.

INACSL has established standards of best practice to help guide debriefings to achieve learning outcomes (INACSL Standards Committee, 2016a...

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