Simulation debriefing for clinical judgment development: A concept analysis

Objective: The aim of this review was to provide an in-depth analysis of debriefing in nursing simulation-based learning. Specifically, the authors sought to describe the debriefing concept within the context of enhancing nursing students' clinical judgment skill. Design: Concept analysis. Data Sources: A literature review was conducted using five electronic databases with the addition of references for relevant papers reviewed. Medline Ovid, Cumulative Index to Nursing and Allied Health (CINAHL) Plus, Educational Resources Information Center (ERIC), ScienceDirect and Google Scholar were searched for articles published in English between 2005 and 2015. Search terms included clinical judgment, debriefing, and simulation. Review Methods: The Walker and Avant systematic approach was utilized as a concept analysis framework. The analysis informed how the concept is defined in the existing literature. Results: The search resulted in a total of 47 articles. The concept of debriefing was analyzed using seven themes from Walker and Avant: concept definition, defining attributes, antecedents, consequences, empirical referents, uses of the concept, and a model case. Based on the analysis, an integrative simulation debriefing guide for promoting students' clinical judgment was presented as a vehicle for a consistent approach. Conclusions: This review identified simulation debriefing as a structured and guided reflection process in which students actively appraise their cognitive, affective, and psychomotor performance within the context of their clinical judgment skill. Reflective debriefing provides students with an opportunity to assume an active role during the learning process. Following a structured debriefing guide can help educators and even students facilitate a learning environment that enhances students' clinical judgment development. (C) 2016 Elsevier Ltd. All rights reserved.