Design and Development of a Temporal Event Annotation Tool to Support Collaborative Debriefing for Nurse Training

Abstract

Within healthcare education, simulation-based training is a popular and successful approach that focuses on providing students with hands-on experiential learning in a controlled, safe, and repeatable environment. Debriefing is considered to be one of the most important components of the simulation process. Debriefing is a feedback approach that encourages learners to critically analyze their performance, identify areas for improvement, and construct new knowledge through directed feedback, reflection, and discussion immediately following an experiential simulation event. However, there are several practical and psychological barriers to effective, best-practice aligned debriefing. Motivated by these challenges, this dissertation aims to reduce barriers to effective simulation debriefing in nursing education by designing and developing a supportive technology tool called PULSE. Through a user-centered design process that engaged nursing instructors and administrators, PULSE was developed to support instructors in addressing several challenges that they face in guiding nursing students through debriefing processes. PULSE is organized around a timeline of “moments”, which are a set of events of pedagogical interest and associated comments marked by instructors and observing students while watching a live simulation. After the simulation concludes, the PULSE system aggregates these marked moments, performs text-based learning analytics on the comments, and presents all this information alongside recorded video of the simulation on an organized debriefing dashboard designed to facilitate discussion among the group. This dissertation presents the user-centered design process of PULSE and a set of field studies that were conducted to refine the dashboard visualizations and evaluate its efficacy. A mixed-methods analysis of the study data revealed that, under the right conditions, PULSE can support improved structure and depth of debriefing conversations, primarily by providing students with increased opportunities to share their input during instructor-guided debriefing discussions. Through the design, development, and analysis of PULSE, this dissertation provides an evidence-centered approach to support a more comprehensive understanding of nurse training scenarios that can lead to deeper reflection among students. In addition, this research contributes new evidence and insights to ongoing discussions in the simulation-based training community about best practices for debriefing and the role of observing students in the debriefing process.