48 Group-based reflective learning conversations model for clinical reasoning skills optimization in multicultural simulated learning environments: a mixed methods comparative study

Background Simulation-based education effectively immerses healthcare professionals in scenarios that mimic clinical situations, mitigate patient safety risks, and practice with focused learning opportunities.¹ Debriefing is an essential part of a simulation and Reflective Learning Conversations (RLC) is a form of simulation debriefing that incorporates empathic, active, and reflective discussions shared between a small group of participants. The RLC is facilitated by a trained/competent facilitator to enhance clinical reasoning skills, hence, improving patients’ outcomes.² The impact of group-based RLC on clinical reasoning levels, especially with contributing factors of scenario complexity, learners’ experiences, seniority, backgrounds, and competence levels in a multicultural learning environment has not been previously investigated.³ This abstract describes the development and validation of a simulation RLC model in consideration of different influencing and contributing factors to optimize clinical reasoning while attending group-based RLC.

Methods The research team (N=18) included doctors, nurses, researchers, educators, and patients who developed the RLC model through a theoretical-driven and conceptual analysis framework. The model’s reliability and validity were evaluated and confirmed through a mixed methods quasi-experimental pre-test-post-test design. Data were collected by survey, direct observations, and focus group. Descriptive and inferential statistical analyses of quantitative data were conducted using SPSS and thematic analysis was conducted for qualitative data.

Results The new model was successfully developed incorporating process pathways and scripted examples (figures 1 and 2). The model was deemed valid and reliable with Cronbach alpha and Intraclass Correlation Coefficient (ICC) (α=0.973, ICC=.973).

Conclusion Optimizing clinical reasoning skills while attending simulation group-based RLC in a multicultural learning environment could challenge healthcare educators. To overcome that challenge, the RLC model was developed and validated in consideration of different contributing and influencing factors and is deemed valid and reliable to be used for group-based simulation-based healthcare education.

References

1. Almomani E, et al. Assessment of clinical reasoning while attending critical care post simulation reflective learning conversation: a scoping review. Dimensions of Critical Care Nursing 2023;42(2):63–82. DOI: 10.1097/DCC.0000000000000567

2. Decker S, Alinier G, Crawford SB, Gordon RM, Jenkins D, Wilson C. Healthcare simulation standards of best practice^TM. The debriefing process. Clinical Simulation in Nursing 2021;58(1):27–32. https://doi.org/10.1016/j.ecns.2021.08.011

3. Tutticci N, et al. Exploring the observer role and clinical reasoning in simulation: a scoping review. Nurse Education in Practice 2022;20:103301. DOI: 10.1016/j.nepr.2022.103301

Ethical Approval/IRB Statement The study was approved by the Institutional Review Board (IRB) of Hamad Medical Corporation (MRC-01-22-117) and the University of Hertfordshire (HSK/PGR/UH/04728).

Disclosures and Acknowledgments The authors have no disclosures or acknowledgements.