Lori Persico

Date of Award


Document Type


Copyright Status, No Creative Commons License

All Rights Reserved

Degree Name

Doctor of Philosophy (Ph.D.) Nursing




Simulation-based education is a teaching method used successfully in military, aviation, and medical education; however, the evidence rarely indicates how debriefing affects the learners’ experiences. Debriefing is an essential component of simulation-based education that fosters conceptual learning, critical thinking, and clinical reasoning. The purpose of this study was to compare the effects of two different debriefing methods on nurses’ perceptions of psychological safety, satisfaction with development of clinical reasoning skills, and satisfaction with learning. In this quasi-experimental, posttest study the researcher explored the effect of each debriefing method. Using the 18-item Satisfaction with Simulation Experience Scale developed by Levett-Jones et al. (2011), the researcher measured learners’ satisfaction with the simulation learning experience. The researcher developed a visual analog scale to measure the learner’s perceived psychological safety. During the simulation learning experience part of an orientation, the researcher used two debriefing methods using the 3D Model of Debriefing: (1) Defusing, Discovering and Deepening (3D-DDD) and (2) the DEBRIEF method. The literature clearly articulates how these models are distinct in how debriefing is executed in the simulation experience. The “debriefers” received appropriate training on the models and were then verified by the investigator for treatment fidelity. After each debrief method, the researcher measured the participants’ experiences including psychological safety and satisfaction, as well as clinical reasoning skills. The researcher divided study participants into two groups and administered one of the two debriefing models. By alternating debrief methods, the researcher ensured that all groups in each month were debriefed using the same method. Both methods resulted in psychological safety and satisfaction. There were no statistically significant differences in either debrief method for the SSES, VAS, and case study scores. The analysis did not identify any meaningful relationships between a learner’s characteristics and satisfaction in debriefing and reflection, self-reported clinical reasoning, and clinical learning. The literature recognizes debriefing as a vital teaching strategy, but there remains minimal research on how to debrief, which methods are effective at achieving learning outcomes, and which are best at fulfilling an individual’s psychological safety.

Related Pillar(s)


Included in

Nursing Commons