Structured Debriefing to Increase Next Generation NCLEX Preparedness: a Tool for Simulation

Abstract : Debriefing offers faculty an opportunity to increase clinical judgment, create a safer nursing workforce, and has the potential to amplify Next Generation NCLEX (NGN) students’ preparedness. Nursing students face significant barriers to passing the NGN due to the natural lag of educational implementation of the NGN and residual effects of remote learning from the Covid pandemic. The literature on debriefing and NGN preparedness is minimal and cannot significantly support any specific debriefing methods as the most effective (Lee et al., 2020). However, literature recommends using structured debriefing to increase clinical judgment (Lee et al., 2020). The purpose of this pilot project is to present a debriefing structure based on Layer Three of the Clinical Judgment Measurement Model (CJMM) theoretical framework and the NGN case studies (NCSBN, 2019). The proposed structure was created to organize prompts for reflective questioning using the six items from Layer Three (NCSBN). One hundred baccalaureate senior nursing students were invited to complete a complex sepsis/GI bleed simulation and debrief using the proposed structure. This pilot project is in progress and results are not completed. The proposed evaluation method for interested faculty includes students’ self-evaluation by a modified Lasater Clinical Judgment Rubric and an NGN-style case study related to the simulation content. Evaluation will occur directly before and after debriefing to evaluate clinical judgment and NGN preparedness. Patient safety and the NGN demands educators focus on clinical judgment. It is anticipated this structured debriefing will drive clinical judgment and the NGN into center stage for simulation education.