Into the black-box of learning in simulation debriefing: A qualitative research study

Abstract Background Simulated learning activities are on the rise worldwide. Debriefing is viewed as a central element in simulated learning to enhance learning. Still, the question of how students learn in debriefing is underexplored. Aim, design and method The paper offers a contribution to the academy to better understand debriefing by presenting an in-depth, qualitative analysis of the practice of debriefing, carried out with 40 first-year nursing students (n = 40) in relation to roleplay simulation, training in clinical decision-making and patient involvement. The simulation sessions were carried out at a university hospital in Copenhagen, Denmark during clinical practice periods. Findings Using theoretical conceptualizations from learning theorist Knud Illeris as sensitizing concepts, the paper points to the emergence of intended as well as unintended learning processes. In addition, it highlights the importance of focusing on facilitators' empowering as well as disempowering impact on students' motivation to engage in debriefing learning processes. An important finding is that the curricular overload leads to a prioritization of learning outcome related to natural science at the expense of “softer” competencies, e.g. patient involvement. The analysis also finds that students' motivation to process their real-life clinical experiences tends to be neglected. The conclusion thus points to a profound dilemma, unidentified in the literature, of learning ambitions in debriefing: the tension between attaining the formal learning objective and thus facilitating a tightly structured and focused debriefing on the one side, and the wish to develop critical and independent thinking on the other.