Repeated Measures of Cognitive and Affective Learning Outcomes in Simulation Debriefing

Abstract

Supplemental Digital Content is Available in the Text. Introduction. To better support the development of domain expertise, there has been considerable interest in the instructional strategies that afford opportunities for problem solving. Simulation-based learning includes case-based activities that support learners' transition into practice through experience and reflective debriefing. Review of the Literature. Simulation-based learning serves as a means for learners to practice psychomotor, affective, and cognitive skills. Although the literature suggests this is an effective strategy for supporting problem-solving skills, much of the literature is focused on measuring cognitive outcomes within a single case. As such, very few studies have simultaneously investigated (a) how debriefing in simulation-based education supports problem solving and (b) the degree to which cognitive and affective learning outcomes are variable throughout the problem-solving process. Methodology. To address this gap, this repeated-measures study examined the role of debriefing strategies in simulation-based learning experiences, which was designed to practice both cognitive and affective skills. In the control condition, participants were given 2 simulation-based laboratory instructional sessions and then assessed on cognitive (problem representation and solution generation) and affective learning (perceived self-efficacy) outcomes. In the comparison condition, participants engaged in debriefing sessions after each of the 2 simulation-based laboratory instructional sessions. For the cognitive outcomes, participants were assessed using the Think-Aloud Standardized Patient Examination instrument, which measured problem representation and solution generation. Acute care confidence survey was used to measure perceived self-efficacy. Results. The study found statistically significant gaps in early-stage measures of cognitive problem representation, but no difference was found in solution generation or perceived self-efficacy measures. Conclusion. This study reinforces the importance of debriefing in simulation-based education. Specifically, this study suggests that cognitive learning outcomes are variable during the problem-solving process, but affective learning outcomes are more fixed and may need more targeted debriefing.