Award Date

May 2023

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Committee Member

Jinyoung Kim

Second Committee Member

Andrew Reyes

Third Committee Member

Catherine Dingley

Fourth Committee Member

Lisa Bendixen

Number of Pages

209

Abstract

Prebriefing is a growing body of knowledge in nursing simulation education. It is recognized as an important factor in the simulation experience, however the practice of prebriefing varies widely making it difficult to understand what methods best prepare students for the simulation scenario. While research over the last decade has identified prebriefing increases confidence, skills, and clinical judgment, what content is important to include in prebriefing, or how it promotes the achievement of outcomes is under recognized.Implementing an intervention based on a pedagogically sound eight-week simulation clinical course, developed with the theoretical underpinnings of Vygotsky’s Zone of Proximal Development, Kolb’s Experiential Learning Theory, and Tanner’s Clinical Judgment model, the purpose of this phenomenological study was to explore the experience of undergraduate senior nursing students who participated in a uniquely structured prebriefing to elucidate the influence of the prebriefing components and elements throughout the simulation experience. Gadamerian hermeneutics provided the philosophical framework of the research as I have extensive knowledge related to the simulation process and how it contributes to the overall experience. The concepts of Tradition, language, and the human sciences provided the philosophical underpinnings of the study. Tradition employs a self-awareness, language provides the ability to interpret the understanding of data collected, and the human sciences provide recognition of the need to develop an understanding between myself and the student. The study took place at a private college in the Midwest. Purposive sampling was used to recruit nine senior students in a 15-month baccalaureate nursing program. Each student completed an eight-week simulation course in which a structured type of prebriefing was implemented. Because this is a simulation course, students experienced prebriefing seven times during an eight-week period, deepening students’ perspectives. A demographic survey was administered to each student to describe the sample. Face-to-face semi-structured interviews of approximately one hour were used to collect data over three months. Analysis using van Manen’s six-steps of hermeneutic phenomenological investigation was concurrent with data collection and continued for another three months. Each interview was recorded, transcribed verbatim, and reviewed for accuracy by both researcher and student. Journal notes were dictated as supplementary data to the research. The essence explicated from the patterns observed through the data analysis process was Linking Knowledge with Nursing Practice. This involved a multifaceted process of students’ experiences in becoming aware of their knowledge and how it is conveyed in nursing practice. It was conceptualized from four main themes: working through it, integrating preparation, expanding awareness, and acknowledging the task. In working through it, students explore their knowledge as it relates to preparing to care for a patient. Integrating preparation demonstrated the relationship between preparation and the remaining simulation experience, identifying the foundational support of preparation and the link to nursing practice. Expanding awareness exposed the perpetuating possibilities related to knowledge required to prepare to care for a patient, but upon that awareness provided students with self-confidence in the process. Lastly, acknowledging the task, revealed the similarities between structured prebriefing and preparing to care for a patient in a real nursing situation. The study findings indicate that a structured prebriefing implemented under a sound theoretical and pedagogically innovative approach to simulation promoted metacognitive and reflective processes that enhanced knowledge development and awareness throughout the simulation experience. These processes further promoted self-efficacy, psychological safety, developed team behaviors, promoted feelings of self-confidence, and provided recognition as to the role of prebriefing in nursing practice. The study findings provide a basis from which future research can build, recognize limitations related to current theoretical design, and present implications for future practice in order to progress the effectiveness of prebriefing during the simulation experience.

Keywords

education; hermeneutic; nursing; prebriefing; qualitative; simulation

Disciplines

Education | Nursing

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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