Debriefing Characteristics Associated With the Development of Clinical Judgment in Nursing Students
DOI:
https://doi.org/10.56200/mentor.v5i15.13654Keywords:
debriefing, clinical judgment, clinical simulation, nursing students, reflectionAbstract
Debriefing was recognized as a phase of clinical simulation associated with reflection on the decisions made and with the development of clinical judgment in nursing students. The objective was to analyze the characteristics of debriefing associated with the development of clinical judgment in nursing students. A narrative and analytical documentary review was conducted covering the period from 2010 to 2026. The analysis was organized into categories related to structure, reflection, facilitation, psychological safety, active participation, blended models, self-debriefing, peer participation, video use, and temporal organization. The development of clinical judgment was found to be mainly associated with structured debriefing aimed at reconstructing the interpretation of the clinical situation, guided by open-ended questions, and conducted in a psychologically safe environment. Self-assessment, peer participation, and audiovisual resources were also found to be useful when integrated into an organized reflective process. No modality or model showed consistent superiority, and the results depended on the interaction among structure, facilitation, reflection, psychological safety, sufficient time, and continuity.
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Al Sabei, S. D., & Lasater, K. (2016). Simulation debriefing for clinical judgment development: A concept analysis. Nurse Education Today, 45, 42–47. https://doi.org/10.1016/j.nedt.2016.06.008
Alnazawi, A., Malone, M., & Raleigh, M. (2026). Pre-registration nursing students’ experiences with debriefing in simulation: A scoping review. Nurse Education in Practice, 94, 104853. https://doi.org/10.1016/j.nepr.2026.104853
Baethge, C., Goldbeck-Wood, S., & Mertens, S. (2019). SANRA—A scale for the quality assessment of narrative review articles. Research Integrity and Peer Review, 4, 5. https://doi.org/10.1186/s41073-019-0064-8
Bajaj, K., Meguerdichian, M., Thoma, B., Huang, S., Eppich, W., & Cheng, A. (2018). The PEARLS healthcare debriefing tool. Academic Medicine, 93(2), 336. https://doi.org/10.1097/ACM.0000000000002035
Cheng, A., Eppich, W., Epps, C., Kolbe, M., Meguerdichian, M., & Grant, V. (2021). Embracing informed learner self-assessment during debriefing: The art of plus-delta. Advances in Simulation, 6, 22. https://doi.org/10.1186/s41077-021-00173-1
Cheng, A., Eppich, W., Grant, V., Sherbino, J., Zendejas, B., & Cook, D. A. (2014). Debriefing for technology-enhanced simulation: A systematic review and meta-analysis. Medical Education, 48(7), 657–666. https://doi.org/10.1111/medu.12432
Cheng, A., Grant, V., Robinson, T., Catena, H., Lachapelle, K., Kim, J., Adler, M., & Eppich, W. (2016). The Promoting Excellence and Reflective Learning in Simulation (PEARLS) approach to health care debriefing: A faculty development guide. Clinical Simulation in Nursing, 12(10), 419–428. https://doi.org/10.1016/j.ecns.2016.05.002
Eppich, W., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10(2), 106–115. https://doi.org/10.1097/SIH.0000000000000072
Fegran, L., ten Ham-Baloyi, W., Fossum, M., Hovland, O. J., Naidoo, J. R., van Rooyen, D. R. M., Sejersted, E., & Robstad, N. (2023). Simulation debriefing as part of simulation for clinical teaching and learning in nursing education: A scoping review. Nursing Open, 10(3), 1217–1233. https://doi.org/10.1002/nop2.1426
Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230–235. https://doi.org/10.1179/2047480615Z.000000000329
Garrison, C. M., Gatchell, E., Hockenberry, K., & Wissemann, J. E. (2026). The impact of video-assisted debriefing on simulation learning outcomes: A rapid review. Clinical Simulation in Nursing, 118, 102029. https://doi.org/10.1016/j.ecns.2026.102029
Ha, E.-H. (2020). Effects of peer-led debriefing using simulation with case-based learning: Written vs. observed debriefing. Nurse Education Today, 84, 104249. https://doi.org/10.1016/j.nedt.2019.104249
Høegh-Larsen, A. M., Ravik, M., Reierson, I. Å., Husebø, S. I. E., & Gonzalez, M. T. (2023). PEARLS debriefing compared to standard debriefing effects on nursing students’ professional competence and clinical judgment: A quasi-experimental study. Clinical Simulation in Nursing, 74, 38–48. https://doi.org/10.1016/j.ecns.2022.09.003
INACSL Standards Committee, Decker, S., Sapp, A., Bibin, L., Brown, M. R., Chidume, T., Crawford, S. B., Fayyaz, J. J., Johnson, B. K., & Szydlowski, J. (2025). The impact of simulation debriefing process on learning outcomes: An umbrella review. Clinical Simulation in Nursing, 101, 101715. https://doi.org/10.1016/j.ecns.2025.101715
INACSL Standards Committee, Decker, S., Sapp, A., Bibin, L., Chidume, T., Crawford, S. B., Fayyaz, J., Johnson, B. K., & Szydlowski, J. (2025). Healthcare Simulation Standards of Best Practice®: The debriefing process. Clinical Simulation in Nursing, 105, 101775. https://doi.org/10.1016/j.ecns.2025.101775
INACSL Standards Committee, DiGregorio, H., Todd, A., Blackwell, B., Brennan, B. A., Repsha, C., Shelton, C. M., Vaughn, J., Wands, L. M., Wruble, E., & Yeager, C. (2025). Healthcare Simulation Standards of Best Practice®: Facilitation. Clinical Simulation in Nursing, 105, 101776. https://doi.org/10.1016/j.ecns.2025.101776
Kang, K., & Yu, M. (2018). Comparison of student self-debriefing versus instructor debriefing in nursing simulation: A quasi-experimental study. Nurse Education Today, 65, 67–73. https://doi.org/10.1016/j.nedt.2018.02.030
Ko, E., & Choi, Y.-J. (2020). Debriefing model for psychological safety in nursing simulations: A qualitative study. International Journal of Environmental Research and Public Health, 17(8), 2826. https://doi.org/10.3390/ijerph17082826
Lavoie, P., Pepin, J., & Cossette, S. (2017). Contribution of a reflective debriefing to nursing students’ clinical judgment in patient deterioration simulations: A mixed-methods study. Nurse Education Today, 50, 51–56. https://doi.org/10.1016/j.nedt.2016.12.002
Lavoie, P., Pepin, J., Cossette, S., & Clarke, S. P. (2019). Debriefing approaches for high-fidelity simulations and outcomes related to clinical judgment in baccalaureate nursing students. Collegian, 26(5), 514–521. https://doi.org/10.1016/j.colegn.2019.01.001
Lee, J., Lee, H., Kim, S., Choi, M., Ko, I. S., Bae, J., & Kim, S. H. (2020). Debriefing methods and learning outcomes in simulation nursing education: A systematic review and meta-analysis. Nurse Education Today, 87, 104345. https://doi.org/10.1016/j.nedt.2020.104345
Mariani, B., Cantrell, M. A., Meakim, C., Prieto, P., & Dreifuerst, K. T. (2013). Structured debriefing and students’ clinical judgment abilities in simulation. Clinical Simulation in Nursing, 9(5), e147–e155. https://doi.org/10.1016/j.ecns.2011.11.009
Niu, Y., Liu, T., Li, K., Sun, M., Sun, Y., Wang, X., & Yang, X. (2021). Effectiveness of simulation debriefing methods in nursing education: A systematic review and meta-analysis. Nurse Education Today, 107, 105113. https://doi.org/10.1016/j.nedt.2021.105113
Oh, Y.-J., Kang, H.-Y., Song, Y., & Lindquist, R. (2021). Effects of a transformative learning theory based debriefing in simulation: A randomized trial. Nurse Education in Practice, 50, 102962. https://doi.org/10.1016/j.nepr.2020.102962
Rossignol, M. (2017). Effects of video-assisted debriefing compared with standard oral debriefing. Clinical Simulation in Nursing, 13(4), 145–153. https://doi.org/10.1016/j.ecns.2016.12.001
Rudolph, J. W., Simon, R., Rivard, P., Dufresne, R. L., & Raemer, D. B. (2007). Debriefing with good judgment: Combining rigorous feedback with genuine inquiry. Anesthesiology Clinics, 25(2), 361–376. https://doi.org/10.1016/j.anclin.2007.03.007
Rueda-Medina, B., Reina-Cabello, J. C., Buendía-Castro, M., Aguilar-Ferrándiz, M. E., Gil-Gutiérrez, R., Tapia-Haro, R. M., Casas-Barragán, A., & Correa-Rodríguez, M. (2024). Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary health professions education: A randomized trial. Nurse Education in Practice, 75, 103901. https://doi.org/10.1016/j.nepr.2024.103901
Sawyer, T., Eppich, W., Brett-Fleegler, M., Grant, V., & Cheng, A. (2016). More than one way to debrief: A critical review of healthcare simulation debriefing methods. Simulation in Healthcare, 11(3), 209–217. https://doi.org/10.1097/SIH.0000000000000148
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204–211. https://doi.org/10.3928/01484834-20060601-04
Tong, L. K., Li, Y. Y., Au, M. L., Wang, S. C., & Ng, W. I. (2022). High-fidelity simulation duration and learning outcomes among undergraduate nursing students: A systematic review and meta-analysis. Nurse Education Today, 116, 105435. https://doi.org/10.1016/j.nedt.2022.105435
Uppor, W., Klunklin, A., Viseskul, N., & Skulphan, S. (2022). A concept analysis of clinical judgment in undergraduate nursing students. Nursing Forum, 57(5), 932–937. https://doi.org/10.1111/nuf.12757
Wazir, T., Sultan, B., Batool, S., & Alhonkoski, M. (2026). Effects of debriefing on clinical judgment among second year nursing students. Teaching and Learning in Nursing, 21(3), e996–e1002. https://doi.org/10.1016/j.teln.2026.01.019
White, H., Hayes, C., Axisa, C., & Power, T. (2021). On the other side of simulation: Evaluating faculty debriefing styles. Clinical Simulation in Nursing, 61, 96–106. https://doi.org/10.1016/j.ecns.2021.08.004
Zhang, H., Mörelius, E., Goh, S. H. L., & Wang, W. (2020). Developing a structured three-phase video-assisted debriefing to enhance prelicensure nursing students’ debriefing experiences, reflective abilities, and professional competencies: A proof-of-concept study. Nurse Education in Practice, 44, 102740. https://doi.org/10.1016/j.nepr.2020.102740
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Copyright (c) 2026 Mariuxi Johanna Zurita Desiderio , Yulitza Geomara Villamar Torres , Vilma Rocío Quijije Chávez , María Priscila Rodríguez Benítez

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