The scenario ends. A student exhales. Someone says, “I should have noticed that sooner.” Another student wonders whether everyone else knew what to do.
For faculty, this is an opportunity to explore what students were thinking—not simply whether they completed the expected tasks.
A planned debrief gives that conversation a purpose. INACSL’s Healthcare Simulation Standards of Best Practice® identify a planned debriefing process as a required part of simulation-based education. That process may include feedback, debriefing, or guided reflection.[1]
The following routines are teaching suggestions you can adapt to your program’s established debriefing approach.
1. Start with a clear learning focus
Before the simulation, identify the learning objectives students will revisit afterward. Explain expectations, roles, and how performance will be evaluated.
For example:
“Today, we’ll focus on recognizing important cues and communicating concerns. Afterward, we’ll discuss what you noticed, how you interpreted it, and what influenced your decisions.”
Give observers a task connected to those objectives. Ask them to note a communication exchange or decision point rather than record every mistake.
2. Give students a moment to gather their thoughts
Consider a brief written reflection before the group discussion:
- What moment stands out?
- What were you thinking at that point?
- What question do you still have?
This gives students something concrete to bring into the conversation. Invite participation without requiring everyone to disclose personal feelings.
If a student says, “I did everything wrong,” help narrow the discussion:
“Let’s look at one decision together. What information did you have at that moment?”
3. Explore a specific decision
Choose a moment related to the learning objectives. Describe what you observed, then ask about the reasoning behind it.
“I noticed the concern was communicated after another task was completed. What influenced that sequence?”
Listen before explaining. The answer may reveal uncertainty about priorities, an overlooked cue, or confusion about responsibilities.
Then guide the group toward the relevant principle:
“What information would help you decide when to communicate that concern?”
Address inaccurate reasoning explicitly. A supportive discussion still needs clear correction and an accurate explanation.
4. Identify what to repeat and what to change
Use two questions to organize part of the discussion:
- “What helped the team?”
- “What would you approach differently next time?”
Ask students to support their answers with observations. “We communicated well” becomes more useful when a learner explains what was said and how the team responded.
AHRQ’s TeamSTEPPS guidance emphasizes reviewing events, examining what worked, identifying improvements, and setting goals without assigning personal blame.[2]
Use these questions within your program’s debriefing method. They should not replace deeper exploration when the scenario exposes a significant misunderstanding.
5. Finish with a specific next step
Ask each student to complete:
“During my next simulation, I will ______ because ______.”
Encourage an observable action. “I will do better” is difficult to revisit. “I will summarize the relevant findings before communicating my concern” gives the student and faculty something to discuss afterward.
Return to that goal during a later practice opportunity. An explanation during debriefing is useful, but it does not by itself establish competency.
Keep preparation manageable
Create a reusable prompt sheet with your objectives, two decision points, and a closing reflection question. Adapt it to each scenario instead of writing an entirely new discussion guide.
Protect adequate debrief time. The appropriate length depends on the learners, objectives, and complexity of the experience. A brief conversation should not be treated as sufficient for every simulation.
For your next simulation day: Choose one decision you want students to explain. Plan the question that will help you understand their reasoning.
References
- International Nursing Association for Clinical Simulation and Learning. Healthcare Simulation Standards of Best Practice®, including “The Debriefing Process,” revised 2025. https://www.inacsl.org/healthcare-simulation-standards
- Agency for Healthcare Research and Quality. (2023). Reviewing the team’s performance: Debrief. TeamSTEPPS. https://www.ahrq.gov/teamstepps-program/curriculum/team/tools/debrief.html
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