HealthMay 22, 2023

Debriefing helps nursing students clarify clinical decisions

In this video interview, Lisa Bonsall, MSN, RN, CRNP, Senior Clinical Editor of, discusses the importance of debriefing nursing students following clinical training with Katie Jett, DNP, RN, MSN, FNP-BC. Dr. Jett is an associate professor and undergraduate program director at Goldfarb School of Nursing at Barnes-Jewish College in St. Louis, MO, with expertise in the advancement of nursing science and education through instructional strategies and transformative learning experiences.

Bonsall opens the discussion by asking Dr. Jett to explain debriefing, which the educator characterizes as the “heart and soul of simulation.” She emphasizes that it “has been extended in the last decade to transition students from action to reflection,” with the goal of focusing on learners to “diffuse their feelings.” This helps the students clarify their thoughts on decisions, enabling them to “refocus in the right way and allow them to reflect and make changes and improvements as they transition to a variety of different care and clinical settings.”

How debriefing helps clinical judgment

Bonsall next probes Dr. Jett on how debriefing can be used to enhance clinical judgment. Wherever the clinical experience happens, Dr. Jett responds that debriefing is an effective “bridge between theory and practice,” with clinical judgment as the ultimate goal. “I’m less concerned about what you [the student] did,” Dr. Jett explains, vs. “understanding why you did it. It’s all about understanding their train of thought, their path to a decision, helping to reframe it to make better decisions in the future.”

Dr. Jett continues, “This enhances clinical judgment because we’re teaching them to think through what they’ve done,” giving students “the step-by-step opportunity to articulate their train of thought.” Dr. Jett also notes that the objective is not to “fix our learners through debriefing” but to help them “make better decisions for their patients,” which is what clinical judgment is all about.

“That’s our job, our role as educators,” she emphasizes, “to help them make sense of the decisions they made or didn’t make” [so] “they can make better and long-lasting decisions in the future.”

That’s our job, our role as educators, to help them make sense of the decisions they made or didn’t make [so] they can make better and long-lasting decisions in the future.
- Katie Jett, DNP, RN, MSN, FNP-BC
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Deconstructing debriefing best practices

Bonsall goes on to ask Dr. Jett how to debrief, asking if there are best practices other educators can follow to be effective. While Dr. Jett says she essentially had to educate herself, she shares the following tips educators can follow to be more effective at debriefing:

  • Seek external education on how to debrief from organizations such as the Society for Simulation, as well as other educators and sources.
  • Observe and model educators who are experts at debriefing.
  • Practice “reflecting and debriefing” on yourself.
  • Observe how students are reacting to your debriefing approach. Are they engaged, or are they shutting down because they feel judged?
  • Seek a faculty assignment in a simulation center as a facilitator to gain practice.
  • Set the stage so students know they are in a safe learning environment.

Creating a safe place to practice

To this last point, Dr. Jett says, “I realized how important being clear with expectations was” when she was learning and honing her own debriefing skills. “Let them [the students] know what they are going to do. It shouldn’t be a surprise.” She adds that educators should tell students they’ll talk about it afterward in a safe environment.

Importantly, she emphasizes that debriefing is not a time to teach. “This isn’t a time to lecture, this is a time to understand the doorway to a decision, the path, why they did something” to “help them critically think, critically judge that situation to make better decisions. That’s the heart and soul of it.”

Dr. Jett explains that not teaching is one of the hardest parts of debriefing for educators, emphasizing that, “You have to check yourself. Because nurse educators are opportunists, we look at every opportunity to teach, but it’s really not about us. It’s about giving them [students] the opportunity to safely show us what they’re doing, what they know, with us clarifying, reframing thoughts to pull out the meat and potatoes of the experience.”

She adds that removing students from the training environment helps because “…it almost always diffuses some of that energy from what they just did.”

Watch the full interview with Lisa Bonsall and explore how virtual simulation can support nursing students in developing clinical judgment.

Nursing Summit Interview with Lisa Bonsall thumbnail image
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Debriefing: It Should Always Be About the Learner
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