Facilitating Reflection-in-Action During High-Fidelity Simulation
Date
2021-10-29
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Abstract
Background: High-fidelity simulation has become common practice in undergraduate nursing education and highly skilled educators are needed to facilitate these complex learning opportunities. Reflective practice is considered an essential step to learning in simulation, starting with reflection-before-action through prebriefing, and ending with reflection-on-action, through debriefing. However, reflection-in-action may be the hallmark of artistry or mastery of a subject. Therefore, undergraduate nursing simulation facilitators need to develop skills to identify and support learners to reflect-in-action. Methods: I conducted a concept analysis to develop an understanding of the phenomena of reflection-in-action during high-fidelity simulation. I then conducted a descriptive phenomenology study with 11 undergraduate nursing simulation facilitators from eight colleges and universities across Alberta. Participants underwent a semi-structured interview, and Colazzi’s seven step process for analysis was utilized to understand the phenomenon of reflection-in-action as experienced by undergraduate nursing simulation facilitators during high-fidelity simulation. Results: Through the concept analysis, I identified four defining attributes of reflection-in-action: (a) reflection-in-action occurs during simulation scenarios; (b) a critical learning juncture occurs and is identified by the learners; (c) a pause in student action occurs; and (d) knowledge sharing through discussion. The experiences of the participants aligned with the findings from the concept analysis. Participants in the study were experienced simulation facilitators. Despite this, they had little formal training regarding reflection-in-action. Participants were able to identify reflection-in-action during high-fidelity simulation when students paused, collaborated, shared their thinking aloud, and changed their course of action. Barriers to reflection-in-action included learner fear and anxiety, poor simulation design, and inadequate preparation. Participants supported reflection-in-action through prebriefing, remaining curious, and providing cues, prompts, or facilitated paused. The benefits of reflection-in-action include collaborative learning, building confidence, critical thinking, and embedding reflection into practice. Conclusions: Phenomenological exploration of experiences of participants was able to add insights to enhance understanding of a poorly defined subject. The insights from this work may enhance simulation facilitator’s ability to effectively support reflection-in-action within high-fidelity simulation. These findings may contribute to theory development, checklists, and decision trees to support the facilitation of reflection-in-action during high-fidelity simulation. Keywords: nursing, education, simulation, reflection, reflection-in-action
Description
Keywords
nursing education, simulation, reflection, reflection-in-action
Citation
Mulli, J. M. (2021). Facilitating Reflection-in-Action During High-Fidelity Simulation (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.