Clinical nursing education in a time of Covid-19: a comparison of virtual and in-person simulation debriefing methods

Abstract

A global COVID-19 pandemic was declared in March, 2020, causing educators and students around the world to pivot toward virtual education when in-person education methods became impossible to safely deliver. This posed unique challenges within nursing education and other disciplines, which historically required experiential or hands-on training. Barriers and disadvantages to traditional in-person clinical nursing education methods such as: limited clinical site availability, competition between schools for clinical sites, cost, increased risk potential, increased patient acuity, decreased average length of hospital stay, and faculty shortages led to exploration of clinical education through in-person and virtual simulation methods predating the COVID-19 pandemic. One of the essential elements of simulation is debriefing, which describes an interactive and reflective discussion of simulation events, which aids in assimilation of new knowledge and ability to apply what is learned in future clinical experiences. The project lead explored and compared 3rd-year nursing student experiences with face-to-face simulation debriefing and virtual debriefing methods. Debriefing Assessment for Simulation in Healthcare survey scores for a small convenience sample of students (n=17) for each debriefing method were collected before and after the COVID-19 mediated educational shift. Qualitative responses were solicited only in the virtual debriefing survey, when students were asked to identify their preference for either face-to-face or virtual debriefing as well as any benefits or challenges associated with each method. Descriptive statistics along with a one-group two-tailed repeated measures Student's T-test was completed for analysis in The Statistical Package for the Social Sciences. T-test results of student scores for each debriefing element were all statistically insignificant at a 95% confidence interval, aside from Element #5 which describes instructor identification of success or failure modes. Student ratings for debriefing quality and subsequent T-test findings suggest that student experience with virtual and face-to-face methods is equal, except with regard to instructor feedback, but are limited due to diminished statistical power. However, qualitative results indicate students uniformly expressed a preference for traditional debriefing methods over virtual simulation debriefing. Virtual simulation debriefing, while not as familiar or easy in terms of communication, appears to be an effective alternative to traditional, face-to-face debriefing.