Debriefing Styles and Clinical Judgment in Nursing Students

December 8, 2025 updated by: Aleix Lopez Oganissian, Universitat Internacional de Catalunya

The Influence of Instructor-centered Versus Learner-centered Debriefing on Clinical Judgment in Nursing Students: A Mixed-methods Experimental Study Protocol.

Simulation is a cornerstone of health sciences education, with debriefing being its most critical component for fostering clinical skills. While various debriefing styles exist, there is limited evidence comparing the effectiveness of instructor-centered (ICT) versus learner-centered (LCT) approaches, specifically on the development of clinical judgment in nursing students.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Several studies suggest a general preference for a Learner-Centered (LCT) style during simulation debriefing. However, existing literature and expert opinion often recommend an Instructor-Centered (ICT) style for novice learners or in time-limited situations. It is critical to note that these recommendations are not consistently based on robust scientific evidence, highlighting a significant gap in nursing education research. This study is designed to address this gap by systematically evaluating the impact of ICT versus LCT debriefing on the acquisition of clinical judgment in undergraduate nursing students-a cornerstone competency for professional practice.

The study's central hypothesis is: "The debriefing style, whether instructor-centered (ICT) or learner-centered (LCT), differently impacts students' learning process in clinical judgment."

To test this hypothesis, the study employs a mixed-methods sequential explanatory design. The initial quantitative phase consists of a randomized controlled trial to determine the effect of the two debriefing styles. This will be followed by a qualitative phase, utilizing focus groups, to explore the students' perceptions and experiences, thereby providing a deeper, contextual explanation for the quantitative findings.

To ensure the integrity of the intervention, methodological fidelity will be rigorously monitored. The distinction between the ICT and LCT styles will be verified through objective measures, including the analysis of faculty-to-student talk-time ratios and the mapping of conversation patterns (sociograms) during debriefing sessions. This ensures that the observed differences in learning can be confidently attributed to the assigned debriefing style. The integration of both quantitative and qualitative data will yield a comprehensive understanding of how different pedagogical approaches in simulation debriefing influence the complex process of clinical judgment development.

Study Type

Interventional

Enrollment (Estimated)

110

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Aleix Lopez Oganissian, MsC, PhDCandidate
  • Phone Number: 93 504 20 00
  • Email: alopezo@uic.es

Study Locations

  • Spain
    • Barcelona
      • Sant Cugat del Vallès, Barcelona, Spain, 08195
        • Recruiting
        • International University of Catalonia
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

-Students enrolled in the Basic Simulation Labs 2 (LBS2) course as part of their program.

Exclusion Criteria:

  • Students who cannot participate in all phases of the study.
  • Students who do not provide informed consent.
  • Students who are repeating the course.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Learner-Centered Debriefing (LCT)
Participants in this group will receive a debriefing guided by a learner-centered (LCT) style, where learning is a dynamic process of meaning-making, and both learners and instructors collaborate in the co-construction of knowledge, skills, and attitudes.
Behavioral: Learner-Centered Debriefing
Two 2-hour simulation sessions followed by a learner-centered debriefing conducted by a trained facilitator. This style emphasizes guided reflection and co-construction of knowledge.
Active Comparator: Instructor-Centered Debriefing (ICT)
Participants in this group will receive a debriefing guided by an instructor-centered (ICT) style, which prioritizes the efficient transfer of information from instructors (who control the learning environments) to learners.
Behavioral: Instructor-Centered Debriefing
Two 2-hour simulation sessions followed by an instructor-centered debriefing conducted by a trained facilitator. This style is the standard practice at the institution and focuses on direct feedback and information transfer from the instructor.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Clinical Judgment Assessed by the Lasater Clinical Judgment Rubric (LCJR)
Time Frame: Assessed at two time points: at Baseline (measurement taken during the first-term practical exam, prior to the intervention) and Post-Intervention (measurement taken during the final practical exam, approximately 3 months after the baseline assessment).
Assessment is performed using the Lasater Clinical Judgment Rubric (LCJR), a validated 11-item tool. During a standardized practical exam (OSCE), trained evaluators will use novel structured checklists developed by the investigators for this study. A unique checklist has been specifically tailored for each OSCE scenario, designed to operationalize the LCJR by mapping observable student behaviors directly to its scoring criteria. Each item is rated on a 4-point scale (1=beginning to 4=exemplary), yielding a total score from 11 to 44. A higher score indicates a more developed level of clinical judgment. For statistical analysis, the raw score will be transformed to a 0-10 scale.
Assessed at two time points: at Baseline (measurement taken during the first-term practical exam, prior to the intervention) and Post-Intervention (measurement taken during the final practical exam, approximately 3 months after the baseline assessment).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Student Perceptions of the Learning Experience Assessed by Focus Group Topic Guide
Time Frame: Up to 3 weeks after the final simulation session.
Perceptions and experiences of students and faculty regarding how different debriefing styles influenced the learning of clinical judgment will be explored through semi-structured focus groups. Data collection will be guided by a Focus Group Topic Guide designed to elicit feedback on the debriefing style, application of theoretical concepts, and the learning experience. The metric for assessment is qualitative, consisting of the identification and categorization of recurring themes and sub-themes derived from the thematic analysis of transcribed discussions.
Up to 3 weeks after the final simulation session.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universitat Internacional de Catalunya

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 10, 2025

Primary Completion (Estimated)

March 1, 2026

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

November 17, 2025

First Submitted That Met QC Criteria

November 22, 2025

First Posted (Estimated)

December 3, 2025

Study Record Updates

Last Update Posted (Estimated)

December 9, 2025

Last Update Submitted That Met QC Criteria

December 8, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • LCTandICTDebriefing&ClinJudge

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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