Collaborative facilitation of debrief after high-fidelity simulation and its implications for reflective thinking: student experiences

Debriefing after high-fidelity simulation (HFS) is a critical element of the reflective process of simulation. Facilitator approaches, styles, and competence can influence the level of reflective thinking by final year undergraduate nurses. It is imperative that debrief facilitators focus on creating an enabling environment to cultivate reflective thinking. Students likewise are challenged to think reflectively within all aspects of their practice. Data collected using ethnographic methods were used to explore the influence of differing types of debrief facilitation approaches on levels of reflective thinking and how this translated to student experiences of HFS and their capacity to provide feedback using a reflective framework. Academic facilitators of HFS debriefs were most likely to engender reflective thinking; however, having an academic involved in the debrief process did not impact on critical reflection. Emotional processing of the simulation was not regularly evidenced, with minimal scaffolding and prompting provided by facilitators. Final year nursing students struggle to critically reflect on their simulation experiences. Interventions are required through direct action and further research to educate these students to critically reflect in both academic and professional practice