ArticleFrontiers in medicine2026
Unlocking the power of reflection: how simulation debriefing shapes clinical decision-making and competence in nursing students.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Simulation debriefing is widely recognized as a critical component of simulation-based education, yet its specific contribution to clinical decision-making and competence development among undergraduate nursing students remains insufficiently explored. Objective: To examine the impact of simulation debriefing on clinical decision-making and nursing competence among nursing students and to determine whether clinical decision-making mediates this relationship. Methods: A multi-center, cross-sectional study was conducted among 650 third- and fourth-year undergraduate nursing students from two XX universities. Participants completed validated instruments assessing debriefing experiences, clinical decision-making, and nursing competence. Data were analysed using Pearson correlation, multiple regression analyses, and mediation analysis using the PROCESS macro. Results: Students demonstrated moderately high levels of debriefing experience, clinical decision-making, and competence. Simulation debriefing showed strong positive associations with both clinical decision-making and competence. Regression analyses identified debriefing quality and clinical rotation frequency as strong predictors. Mediation analysis revealed a significant partial mediation effect, indicating that debriefing improves competence partly by strengthening clinical decision-making processes. Conclusions: Simulation debriefing plays a pivotal role in enhancing students' cognitive integration of simulation experiences, supporting the development of informed clinical judgment and competence. Strengthening debriefing practices is therefore essential for advancing simulation-based nursing education and supporting readiness for clinical practice.
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