Rubric-based debriefing to enhance nursing students' critical thinking via simulation.

Introduction: Debriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning. Objectives: We evaluated the effects of rubric-based debriefing on students' critical thinking, level of confidence in performing tasks and communication. Method: This is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question. Results: Based on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students' critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities. Conclusions: This is the first study to provide evidence that a rubric-based debriefing enhances students' critical thinking in simulation learning.