Debrief for Relief

Melissa Ackerly, BS, RN

SUNY Delhi School of Nursing
Melissa Ackerly is a faculty member and instructor in the School of Nursing at the
State University of New York at Delhi. She supervises the operations and instruction of
students in the Nursing Learning Laboratory, and oversees the video and skill testing
program. Melissa is a graduate of SUNY Delhi’s associate and RN to BSN programs,
and is currently a student in the masters of science in nursing education program at
SUNY Delhi. Her clinical expertise is in outpatient multi-specialty care and school-
based health care.
Objectives
At the conclusion of this session the attendees will be able to;
1) Explain the implications of using debriefing in nursing student education.
2) Discuss how students may exhibit anxiety and stress in a clinical or simulation
environment.
3) Describe opportunities which debriefing would enhance nursing student learning.
Purpose
The purpose of this session is to promote the use of debriefing in nursing education as
a valuable teaching strategy which encourages self-reflection and resiliency. Nursing
students experience stress in anxiety provoking situations such as direct patient care
or simulations (Schmidt & Haglund, 2017). Debriefing in undergraduate nursing
education has traditionally been highly structured for post-simulation experiences.
There is little evidence in the literature of superior methods or use for debriefing
(Dufrene & Young, 2014). Debriefing is under-utilized in nursing education.
Introduction
Making mistakes is human. Making mistakes in nursing care is frightening to nursing
students. Post-conference discussion as a debriefing session of the clinical day are an
opportunity for students to share their experiences and feelings (Gaberson, Oermann,
& Shellenbarger, 2015). Students can reflect on their feelings and performance
through examining their responses to their performance, understanding and discussing
what went wrong, and what changes would improve the outcome.
Methodology
 Case study
 Interactive group participation
 Debriefing exercise
  Open discussion
The attendees will participate in an interactive case as the instructor for six pre-
licensure nursing students in the clinical setting. One of the students has had an
extremely difficult day. As a collective group, the attendees will participate in a
debriefing exercise guided by the facilitator. Open discussion of the debriefing
activity and identifying application opportunities in nursing education will follow.
Evaluation/Results
Recent findings report the value of debriefing on student performance and confidence
even if it is performed in short impromptu sessions. The students learn to explore
what they intended to do with the outcome and the desired outcome. Students
benefit from debriefing in stress/anxiety reduction and development of self-reflective
skills in a low-risk setting (Eppich, Mullan, Brett-Fleegler & Cheng, 2016).
Conclusions/Recommendations
Debriefing is evidence-based to promote learning the culture of communication and
feedback (Eppich, Mullan, Brett-Fleegler & Cheng, 2016). Making mistakes is the
impetus for change and debriefing allows for reducing anxiety and stress and
improved student confidence in their performance. Instructors should be vigilant in
looking for signs of anxiety related distress in students to provide debriefing as an
intervention.
References
Dufrene, C. C., & Young, A. (2014). Successful debriefing: Best methods to achieve
positive learning outcomes: A literature review. Nurse Education Today, 34(3),
372-376. doi:10.1016/j.nedt.2013.06.026
Eppich, W. J., Mullan, P. C., Brett-Fleegler, M., & Cheng, A. (2016). “Let's talk about
it”: Translating lessons from health care simulation to clinical event debriefings
and coaching conversations. Clinical Pediatric Emergency Medicine, 17(3), 200-
211. doi:10.1016/j.cpem.2016.07.001
Gaberson, K. B., Oermann, M. H., & Shellenbarger, T. (2015). Clinical teaching
strategies in nursing (4th ed.). New York, NY: Springer.
Schmidt, M., & Haglund, K. (2017). Debrief in emergency departments to improve
compassion fatigue and promote resiliency. Journal of Trauma Nursing, 24(5),
317-322. doi:10.1097/JTN.0000000000000315