Students/Faculty: Please answer 3 research questions: High-fidelity simulation

1. Do you facilitate or participate in debriefing sessions following high-fidelity simulations?

I have participated as a student in debriefing following high-fidelity simulations. Your link mentioned the use of reflection in education. I participated in reflection in the nursing educational setting, also. They were not the same.

2. Do you feel that you (or your students) have an opportunity to reflect during debriefing? If so, how?

No reflection was done during debriefing. Students were asked specific questions by nurse educators - reflection would be more open, and freer with students able to bring up their own personal feelings or concerns. Mostly, the nurse educators I had were not trust worthy for reflection, because they discriminated against students. Reflection was used by nurse educators to mark and eliminate students who were not desired, based upon thoses students personality or belief traits.

3. What are your beliefs about student reflection following simulation experiences?

Reflection is useless, without trust worthy nurse educators who do not discriminate. At least if nurse educators gave students clues as to what is or is not acceptable, students might be able to change and conform their beliefs and ideals. This was not the case in my program. Reflection, in my program, was an invasion of privacy. There was so much "reflection," you'd have to really good at lying, and at guessing, to get anything right. Nurse educators were derogatory, and excessively critical of student reflections. It seemed like reflection excercises were intended to discourage communication in the work field. It would be better to have models of desired communication examples, and clear guidelines as to what is not desired in the work field.

As a student nurse I have participted in debriefing sessions. Students are biased during reflection processess because thier teachers are the ones leading the debriefing and reflection process and students feel they are being judged and graded. Students are reflecting afterwards about how much they dislike the experience and the teachers, not about the simulation/senario itself! Simulations should be taught and run by seperate staff that do not teach regular classes in the nursing program so as not to be biased. These staff should be proficient at running the senarios and seperate from the administration staff that run the actual lab - they are two different jobs. The administration staff should not also be teachers in the nursing dept either. Student workers should help admin staff and help set up and take down senarios but should not be running them or be actors in them because again thier is potential for bias which effects the students learning experience.

I'll answer your questions based on my experience as a student participating in simulations in the lab setting. All simulations were done with mannequins that were interactive (they had breath sounds, pulse, BP, recorded voices, and critical care information displayed on a bedside monitor)

1. Do you facilitate or participate in debriefing sessions following high-fidelity simulations? I'm not really sure what "high-fidelity" means, but we did have debriefing immediately after each individual simulation.

2. Do you feel that you (or your students) have an opportunity to reflect during debriefing? If so, how? Absolutely. Often times the first thing we were asked by the instructor is "How do you think it went?". The instructor would have a list of observations about how we performed, assessments/implementations, statements we made, interaction with other "personnel", etc. Our instructors would let us know where we were strong, where we were weak, and things to consider reviewing. Our instructors would go over any questions and concerns we had about the simulation, and they would always be sure to review how the scenario would play out in the "perfect world".

3. What are your beliefs about student reflection following simulation experiences? I think they placed a vital role in my development into the role of a nurse. Personally, I learn the best through hands on experience. Through lab experiences and the reflections that followed, I was able to get hands on experience doing assessments, skills, and prioritization when things are moving at a fast pace. This is an experience that we never really got in the clinical setting as a student (aside from preceptorship). The time for reflections allowed me to slow down and evaluate my performance, realize the things that I did, and the things that I should have done. Also, it provided a time for my instructor to give one on one evaluation of my performance and the areas I need to work on developing.

If this isn't the type of response you're looking for, PM me and I'll see if I can clarify.

Thanks for your posts everyone.

High-fidelity means life-like. High-fidelity manikins are the high-tech manikins (SimMan, MEDI) that can be computer programed to show vital signs on a monitor, drop BP, change cardiac rhythms. Catheters can be inserted, IV fluids can be infused and the instructor can use voice over-technology to seem like the manikin is speaking.

I agree that reflection differs from debriefing. Here are a few more questions for anyone to answer:

How does reflection differ from debriefing?

When you reflect on a simulation, what is going on in your mind?

How important is the role of the instructor in facilitating reflection? What is helpful? What is not?

Again, I appreciate your time in answering these questions. Hopefully, one day there will be a "model of communication" that Care1 spoke of in the post!