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Rubric-based debriefing to enhance nursing students’ critical thinking via simulation
  1. Janet Yuen Ha Wong,
  2. Maggie Mee Kie Chan,
  3. Vivien Wai Yin Tsang,
  4. Michelle Tsz Ha Pang,
  5. Claudia Kor Yee Chan,
  6. Pui Hing Chau,
  7. Agnes Tiwari
  1. School of Nursing, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Dr Janet Yuen Ha Wong, School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong; janetyh{at}


Introduction Debriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning.

Objectives We evaluated the effects of rubric-based debriefing on students’ critical thinking, level of confidence in performing tasks and communication.

Method This is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question.

Results Based on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students’ critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities.

Conclusions This is the first study to provide evidence that a rubric-based debriefing enhances students’ critical thinking in simulation learning.

  • simulation education
  • nursing student
  • rubric
  • debriefing

Statistics from


  • Contributors JYHW is the project leader, developed the research design and drafted the manuscript. MMKC, VWYT, MTHP and CKYC developed the case scenarios, implemented simulation activities and drafted the manuscript. PHC developed the research design, analysed and interpreted the data, reviewed the manuscript. AT developed the overall research design and provided expert advice on simulation education.

  • Funding This study was supported by a Teaching Development Grant (Project no. 16/611) awarded by the University Grants Council in Hong Kong.

  • Competing interests None declared.

  • Ethics approval Ethical approval was gained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (HKU/HA HKW IRB Ref. UW 16-556).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Not applicable.

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