{"title":"Debriefing to nurture clinical reasoning in nursing students: A design-based research study","authors":"Jettie Vreugdenhil , Louti Broeksma , Carolyn Teuwen , Eugène Custers , Marcel Reinders , Jos Dobber , Rashmi A. Kusurkar","doi":"10.1016/j.nedt.2024.106402","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Students' clinical reasoning can be stimulated by guiding them to use their experiences with patients to develop own illness scripts. Debriefing during hospital shifts invites students to put patient experiences into words, link them to previously acquired knowledge and make connections.</p></div><div><h3>Objectives</h3><p>To develop, implement and evaluate a debriefing procedure for nursing internships based on illness script theory and generate corresponding design principles.</p></div><div><h3>Design</h3><p>Qualitative design-based research.</p></div><div><h3>Setting</h3><p>Clinical education in dedicated educational hospital units.</p></div><div><h3>Participants</h3><p>Nurse educators, nursing students.</p></div><div><h3>Methods</h3><p>From a collaboration between nurse educators and a researcher, a short, peer-debriefing procedure was designed, tested and enacted through four cycles of planning, action, evaluation and reflection. Students drew mind maps about patients. Nurse educators and students joined focus group discussions to evaluate outcomes and processes. Mind map and iterative thematic analysis were applied to these data.</p></div><div><h3>Results</h3><p>An adjusted design and more extensive design principles resulted. Differences in mind maps were evident over time. Three themes in the process evaluation were established: trigger to reason; energy giving and taking; and form follows function.</p></div><div><h3>Conclusions</h3><p>This design-based investigation displays how nurse educators could design and implement a debriefing procedure to facilitate students' clinical reasoning skills and how students could learn from this. This method integrates research, innovation and collaboration. The design and enactment under real-life hospital conditions generated design principles for educators and researchers which may be useful for those seeking to improve teaching and learning clinical reasoning in practice. More clarification is needed about the path from design through enactment to real change in practice.</p></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"143 ","pages":"Article 106402"},"PeriodicalIF":3.6000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0260691724003125/pdfft?md5=c32eaa14a41407382cb1b8af55215bdf&pid=1-s2.0-S0260691724003125-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nurse Education Today","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0260691724003125","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
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Abstract
Background
Students' clinical reasoning can be stimulated by guiding them to use their experiences with patients to develop own illness scripts. Debriefing during hospital shifts invites students to put patient experiences into words, link them to previously acquired knowledge and make connections.
Objectives
To develop, implement and evaluate a debriefing procedure for nursing internships based on illness script theory and generate corresponding design principles.
Design
Qualitative design-based research.
Setting
Clinical education in dedicated educational hospital units.
Participants
Nurse educators, nursing students.
Methods
From a collaboration between nurse educators and a researcher, a short, peer-debriefing procedure was designed, tested and enacted through four cycles of planning, action, evaluation and reflection. Students drew mind maps about patients. Nurse educators and students joined focus group discussions to evaluate outcomes and processes. Mind map and iterative thematic analysis were applied to these data.
Results
An adjusted design and more extensive design principles resulted. Differences in mind maps were evident over time. Three themes in the process evaluation were established: trigger to reason; energy giving and taking; and form follows function.
Conclusions
This design-based investigation displays how nurse educators could design and implement a debriefing procedure to facilitate students' clinical reasoning skills and how students could learn from this. This method integrates research, innovation and collaboration. The design and enactment under real-life hospital conditions generated design principles for educators and researchers which may be useful for those seeking to improve teaching and learning clinical reasoning in practice. More clarification is needed about the path from design through enactment to real change in practice.
期刊介绍：
Nurse Education Today is the leading international journal providing a forum for the publication of high quality original research, review and debate in the discussion of nursing, midwifery and interprofessional health care education, publishing papers which contribute to the advancement of educational theory and pedagogy that support the evidence-based practice for educationalists worldwide. The journal stimulates and values critical scholarly debate on issues that have strategic relevance for leaders of health care education.
The journal publishes the highest quality scholarly contributions reflecting the diversity of people, health and education systems worldwide, by publishing research that employs rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of education and systems globally. The journal will publish papers that show depth, rigour, originality and high standards of presentation, in particular, work that is original, analytical and constructively critical of both previous work and current initiatives.
Authors are invited to submit original research, systematic and scholarly reviews, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing and related health care education, and which will meet and develop the journal''s high academic and ethical standards.
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