Debriefing associated with simulated practice in midwifery education: scoping review
DOI:
https://doi.org/10.29352/mill0229.44551Keywords:
debriefing; clinical simulation; maternal and obstetric specialist nurse; health educationAbstract
Introduction: Training Specialist Nurses in Maternal and Obstetric Health (EEESMOs) requires preparing professionals for complex and emotionally demanding clinical situations. Clinical simulation with structured debriefing is essential to develop technical and non-technical skills, confidence, and reflective learning.
Objective: Maps the evidence on debriefing linked to simulated practice in EEESMOs training, identifying models, competencies developed, and barriers and facilitators.
Methods: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, we searched multiple databases and grey literature for studies on debriefing in maternal and obstetric nursing simulation.
Results: Eleven studies from diverse regions met the inclusion criteria. Structured debriefing models such as Advocacy-Inquiry and Diamond Debriefing predominated, mostly with high-fidelity simulation. Results show significant improvements in technical skills for obstetric emergencies and non-technical skills, including communication, critical thinking, decision-making, and emotional regulation. Participants reported greater confidence and readiness for clinical practice. Barriers included limited resources and insufficient facilitator training; experienced facilitators and structured models were used.
Conclusion: Structured debriefing with simulated practice enhances essential competencies, supporting safer maternal and obstetric care. Innovative methods like escape rooms hold promise for engagement and skill acquisition. Future studies should explore long-term impacts and compare debriefing models, including novel simulation approaches.
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References
Amod, H. B., & Brysiewicz, P. (2019). Promoting experiential learning through the use of high-fidelity human patient simulators in midwifery: A qualitative study. Curationis, 42(1), e1-e7. https://doi.org/10.4102/curationis.v42i1.1882
Atasever, İ., Çalık, A., & Duran, E. T. (2025). The digital escape room developed for nursing students: GestDia. BMC Medical Education, 25(1), 981. https://doi.org/10.1186/s12909-025-07548-2
Brasil, G. d. C., Ribeiro, L. M., Mazzo, A., Almeida, R. G. d. S., Martins, J. C. A., Fonseca, L. M. M., & Ponce de Leon, C. G. R. M. (2018). Use of the design and self-confidence scales in the assessment of maternal-child realistic simulation. Revista de Enfermagem Referência, IV (19), 117-126. https://doi.org/10.12707/RIV18025
Çakmak, B., & Kaymaz, T. T. (2024). The effect of an escape room game on students’ academic self-efficacy and motivation for critical thinking: Oncology nursing course. BMC Nursing, 23, 910. https://doi.org/10.1186/s12912-024-02586-5
Cant, R. P., & Cooper, S. J. (2016). Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Education Today, 49, 63–71. https://doi.org/10.1016/j.nedt.2016.11.015
Cheng, A., Palaganas, J., Eppich, W., Rudolph, J., Robinson, T., & Grant, V. (2015). Co-debriefing for simulation-based education: A primer for facilitators. Simulation in Healthcare, 10(2), 69–75. https://doi.org/10.1097/sih.0000000000000077
Coffey, F. (2015). Learning by simulation – is it a useful tool for midwifery education? New Zealand College of Midwives Journal, 51, 31-37. https://encurtador.com.br/Wzdl
Coutinho, V. R. D., Martins, J. C. A., & Pereira, M. de F. C. R. (2014). Construction and validation of the Simulation Debriefing Assessment Scale (EADaS). Revista de Enfermagem Referência, 4(2), 41–50. https://doi.org/10.12707/RIII1392
Dias, J. M., Abraham, M. S., Subu, M. A., Al-Yateem, N., & Ahmed, F. R. (2024). Simulation as an innovative teaching pedagogy for baccalaureate male students undertaking a maternal health course in the Arab world: A pilot project. International Journal of Nursing Education, 16(1), 27-30. https://doi.org/10.37506/qnt6qx32
Dreifuerst, K. T. (2012). Using debriefing for meaningful learning to foster development of clinical reasoning in simulation. Journal of Nursing Education, 51(6), 326–333. https://doi.org/10.3928/01484834-20120409-02
Fanning, R. M., & Gaba, D. M. (2007). The role of debriefing in simulation-based learning. Simulation in Healthcare, 2(2), 115–125. https://doi.org/10.1097/SIH.0b013e3180315539
Fernandes, C. S., Moreira, M. T., Ferreira, M. S., Funghetto, S. S., Stival, M. M., & Lima, A. M. N. (2025). Exploring the use of escape rooms in nursing. Nurse Education in Practice, 60, 103350. https://doi.org/10.1016/j.nepr.2025.104324
Gardner, R. (2013). Introduction to debriefing. Seminars in Perinatology, 37(3), 166–174. https://doi.org/10.1053/j.semperi.2013.02.008
Ghiamikeshtgar, N., Ghaljaei, F., Ghaljeh, M., Taherizade, B., Mahmoodi, N., & Sharifi, S. (2024). The effect of escape room clinical evaluation method on satisfaction, learning, and preparedness to practice as interns of nursing students: A quasi-experimental quantitative study. Journal of Education and Health Promotion, 13, 225. https://doi.org/10.4103/jehp.jehp_711_23
INACSL Standards Committee, Watts, P. I., McDermott, D. S., Alinier, G., Charnetski, M., & Nawathe, P. A. (2021). Healthcare Simulation Standards of Best PracticeTM Simulation Design. Clinical Simulation in Nursing, 58, 14-21. https://doi.org/10.1016/j.ecns.2021.08.009
Jaye, P., Thomas, L., & Reedy, G. (2015). ‘The Diamond’: A structure for simulation debrief. The Clinical Teacher, 12(3), 171-175. https://doi.org/10.1111/tct.12300
Knight, C. C., Dailey, K. D., & Currie, E. R. (2015). An introduction to unexpected grief for pre-licensure nursing students: A simulation and interprofessional expert panel regarding fetal demise. Nursing Education Perspectives, 36(6), 414-416. https://doi.org/10.5480/14-1302
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice-Hall.
Lutgendorf, M. A., Spalding, C., Drake, E., Spence, D., Heaton, J. O., & Morocco, K. V. (2017). Multidisciplinary in situ simulation-based training as a postpartum hemorrhage quality improvement project. Military Medicine, 182(3), e1762-e1766. https://doi.org/10.7205/MILMED-D-16-00030
Macdiarmid, R., Neville, S., & Zambas, S. (2020). The experience of facilitating debriefing after simulation: A qualitative study. Nursing Praxis in Aotearoa New Zealand, 36(3), 51–60. https://doi.org/10.36951/27034542.2020.015
Moloney, M., Murphy, L., Kingston, L., Markey, K., Hennessy, T., Meskell, P., Atkinson, S., & Doody, O. (2022). Final year undergraduate nursing and midwifery students’ perspectives on simulation-based education: A cross-sectional study. BMC Nursing, 21(1), 299. https://doi.org/10.1186/s12912-022-01084-w
Nazim, S. M., & Riaz, Q. (2021). Simulation based team training in surgery – A review. Journal of the Pakistan Medical Association, 71(Suppl 1)(1), S77–S82. https://pubmed.ncbi.nlm.nih.gov/33582728/
Psyllou, M. (2024). Escape the classroom: A game to improve learning and student engagement. 10th International Conference on Higher Education Advances (HEAd’24). Polytechnic University of Valencia. https://doi.org/10.4995/HEAd24.2024.17351
Raney, J. H., Medvedev, M. M., Cohen, S. R., Spindler, H., Ghosh, R., Christmas, A., Das, A., Gore, A., Mahapatra, T., & Walker, D. (2020). Training and evaluating simulation debriefers in low-resource settings: Lessons learned from Bihar, India. BMC Medical Education, 20(1), 9. https://doi.org/10.1186/s12909-019-1906-2
Reinkemeyer, E. A., Chrisman, M., & Patel, S. E. (2022). Escape rooms in nursing education: An integrative review of their use, outcomes, and barriers to implementation. Nurse Education Today, 119, 105571. https://doi.org/10.1016/j.nedt.2022.105571
Rudolph, J. W., Simon, R., Dufresne, R. L., & Raemer, D. B. (2006). There's no such thing as “nonjudgmental” debriefing: A theory and method for debriefing with good judgment. Simulation in Healthcare, 1(1), 49–55. https://doi.org/10.1097/01266021-200600110-00006
Rudolph, J. W., Simon, R., Rivard, P., Dufresne, R. L., & Raemer, D. B. (2007). Debriefing with good judgment: Combining rigorous feedback with genuine inquiry. Anesthesiology Clinics, 25(2), 361–376. https://doi.org/10.1016/j.anclin.2007.03.007
Sawyer, T., Eppich, W., Brett-Fleegler, M., Grant, V., & Cheng, A. (2016). More than one way to debrief: A critical review of healthcare simulation debriefing methods. Simulation in Healthcare, 11(3), 209–217. https://doi.org/10.1097/SIH.0000000000000148
Silva, S. C. N., Alencar, B. R., Viduedo, A. F. S., Ribeiro, L. M., Ponce de Leon, C. G. R. M., & Schardosim, J. M. (2021). Management of severe preeclampsia in the puerperium: Development and scenario validation for clinical simulation. Revista Brasileira de Enfermagem. 74(6). https://doi.org/10.1590/0034-7167-2020-0445
Sivertsen, N., McNeill, L., & Muller, A. (2016). A redo station after debrief improves learning in undergraduate nursing simulation. Clinical Simulation in Nursing, 12(11), 469-472. https://doi.org/10.1016/j.ecns.2016.07.007
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