The relationship between facilitators' questions and the level of reflection in postsimulation debriefing.
BACKGROUND
Simulation-based education is a learner-active method that may enhance teamwork skills such as leadership and communication. The importance of postsimulation debriefing to promote reflection is well accepted, but many questions concerning whether and how faculty promote reflection remain largely unanswered in the research literature. The aim of this study was therefore to explore the depth of reflection expressed in questions by facilitators and responses from nursing students during postsimulation debriefings.


METHODS
Eighty-one nursing students and 4 facilitators participated. The data were collected in February and March 2008, the analysis being conducted on 24 video-recorded debriefings from simulated resuscitation teamwork involving nursing students only. Using Gibbs' reflective cycle, we graded the facilitators' questions and nursing students' responses into stages of reflection and then correlated these.


RESULTS
Facilitators asked most evaluative and fewest emotional questions, whereas nursing students answered most evaluative and analytic responses and fewest emotional responses. The greatest difference between facilitators and nursing students was in the analytic stage. Only 23 (20%) of 117 questions asked by the facilitators were analytic, whereas 45 (35%) of 130 students' responses were rated as analytic. Nevertheless, the facilitators' descriptive questions also elicited student responses in other stages such as evaluative and analytic responses.


CONCLUSIONS
We found that postsimulation debriefings provide students with the opportunity to reflect on their simulation experience. Still, if the debriefing is going to pave the way for student reflection, it is necessary to work further on structuring the debriefing to facilitate deeper reflection. Furthermore, it is important that facilitators consider what kind of questions they ask to promote reflection. We think future research on debriefing should focus on developing an analytical framework for grading reflective questions. Such research will inform and support facilitators in devising strategies for the promotion of learning through reflection in postsimulation debriefings.
Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway. sissel.i.husebo@uis.no
Sissel Eikeland
SE
Husebø
Peter
P
Dieckmann
Hans
H
Rystedt
Eldar
E
Søreide
Febe
F
Friberg
D000328:Adult; D004508:Education, Nursing, Baccalaureate; D005260:Female; D006801:Humans; D008297:Male; D008348:Manikins; D008875:Middle Aged; D016544:Patient Simulation; D018794:Problem-Based Learning / Q000379:methods*; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology*; D014741:Video Recording; D055815:Young Adult