Simulation is a time- and cost-intensive teaching modality that consists of both hands-on experience with a lifelike manikin and a debriefing session. While many educators believe that both simulation components are important for learning, the impact of the individual components is unknown.



The purpose of this study was to determine where in a simulation experience greater knowledge gains occurred



With a 2-group, repeated measures, experimental design, this study examined the impact of simulation components (hands-on alone and hands-on plus debriefing) on heart failure (HF) clinical knowledge in 162 prelicensure nursing students (age: M = 25.7 years, SD = 6.6 years; 85.5% women) from 3 nursing schools who were at the same point in their curriculum. Parallel HF knowledge tests were given at baseline (Pretest) and after the hands-on (Posttest 1) and debriefing (Posttest 2) stages of the HF simulation.



HF knowledge scores decreased from the pretest to the first posttest (after the hands-on component of the simulation; M = −5.63, SD = 3.89; p < .001), whereas they dramatically improved after debriefing (M = +6.75, SD = 4.32; p = < .001).



Gains in HF knowledge were achieved only after debriefing. This study suggests that the debriefing experience should be emphasized in a standardized simulation learning experience. Further investigation is needed to evaluate the impact of debriefing and intensive teaching without the hands-on simulation component.


KeyWords: debriefing; nursing education; simulation; research simulation