• Expect the Unexpected: Unraveling Learner Perceptions through Simulation and Debriefing Using Critical Conversations

      Loomis, Ann; Kaye Wooton, Angelea
      Simulation is an innovative teaching strategy that bridges classroom learning and clinical experience. Beginner students can work at building confidence in performing fundamental skills while experts can expand their knowledge base. While simulation has primarily been used to improve clinical competencies, little work has been accomplished in promoting critical conversations with the learner.  The simulation environment allows learners to make mistakes while gaining powerful insight into the consequences of their actions. A simulated clinical experience followed with debriefing provides the opportunity for learners to actively engage and participate in reflective discussions of the experience through critical conversations. These critical conversations enhance learning and advance critical thinking (Jeffries, Dreifuerst, Kardong-Edgren, & Hayden, 2015).  Simulation can have a powerful impact on learning. The International Nursing Association for Clinical Simulation and Learningsm (INASCL) is the global organization that maintains standards to promote excellence in healthcare simulation.  INACSL (2017) recommends that all simulation experiences begin with the creation of a prebrief environment where learners feel safe to participate in potentially uncomfortable situations. During the prebrief, all simulation-base experiences need to develop measurable objectives which assist learners in achieving expected outcomes. Objectives should be developed prior to the simulation using the SMART framework: specific, measurable, assignable, realistic, and time related. Simulation-based education should adhere to the criterion put forth in the standards to facilitate expected outcomes (Lioce et al. 2015).  Following the simulation, a planned theory-based debriefing component will assist learners through several stages of discussion used in critical conversations: an initial reaction phase, an analysis phase, and ending with the final phase of summarizing learning (Forneris & Fey, 2016). Critical conversations structured within the debriefing help guide thinking and understanding for both facilitator and learner. It is in the debriefing where essential learning occurs (O’Brien, Hagler & Thompson, 2015). Critical conversations can be used across multiple disciplines and beyond the classroom. Creating an environment which promotes learner engagement and transference of knowledge will assist in development of the learners’ professional roles. While facilitation extends well beyond the simulation experience, critical conversations aim to support learners to think critically in any environment (O’Brien, Hagler & Thompson, 2015).