Debriefing: The Most Important Component in Simulation?

Background: Simulation is a time- and cost-intensive teaching modality that consists of both hands-on experience with a lifelike manikin and a debriefing session. While many educators believe that both simulation components are important for learning, the impact of the individual components is unknown. Objectives: The purpose of this study was to determine where in a simulation experience greater knowledge gains occurred. Methods: With a 2-group, repeated measures, experimental design, this study examined the impact of simulation components (hands-on alone and hands-on plus debriefing) on heart failure (HF) clinical knowledge in 162 prelicensure nursing students (age: M = 25.7 years, SD = 6.6 years; 85.5% women) from 3 nursing schools who were at the same point in their curriculum. Parallel HF knowledge tests were given at baseline (Pretest) and after the hands-on (Posttest 1) and debriefing (Posttest 2) stages of the HF simulation. Results: HF knowledge scores decreased from the pretest to the first posttest (after the hands-on component of the simulation; M = -5.63, SD = 3.89; p < .001), whereas they dramatically improved after debriefing (M = +6.75, SD = 4.32; p = < .001). Conclusion: Gains in HF knowledge were achieved only after debriefing. This study suggests that the debriefing experience should be emphasized in a standardized simulation learning experience. Further investigation is needed to evaluate the impact of debriefing and intensive teaching without the hands-on simulation component.