Date of Award

Spring 5-2016

Document Type


Degree Name

Doctor of Philosophy (PhD)


Nursing and Allied Health Professions

First Advisor

Teresa C. Shellenbarger, Ph.D.

Second Advisor

Kristy S. Chunta, Ph.D.

Third Advisor

Christoph Maier, Ph.D.


Simulation provides an avenue to prepare nursing students to provide high-quality nursing care in the complex health-care environment. Debriefing, an aspect of simulation, is used to enhance student learning through a reflective discussion. Limited empirical evidence suggests the best approach to debrief that best enhances nursing students’ reflection. Reflection is paramount in developing the type of thinking required for nursing.

This study examined the influence of high-fidelity simulation and video-assisted debriefing (VAD) on the personal reflection ability of undergraduate sophomore-level nursing students. This study also explored if the personal variables of previous healthcare experience and GPA influenced reflection ability. Schӧn’s work on reflection was used to guide this study.

A descriptive one group pre-test-post-test repeated measures design was used before and immediately after three different simulation and VAD experiences. The Groningen Reflection Ability Scale (GRAS) was used to assess reflection ability. The sample included sophomore-level nursing students from a large state university. Descriptive statistics and a mixed between-within subject’s analysis of variance were used.

Findings revealed statistical significance regarding reflection ability over time (Wilks’ Lambda = .829, F (3, 93) = 6.384, p =.001). The personal variables of previous healthcare experience (F (1, 95) = .511, p = .476) and GPA (F (1, 95) = 1.07, p = .303) had no effect initially on reflection ability. Nor did both personal variables combined reveal statistical significance (F (1, 95) = .010, p =.922). Also, personal variables did not have statistical significance over time in regards to previous healthcare experience (Wilks’ Lambda = .959, F (3, 93) = 1.31, p = .276, partial eta squared = .041), GPA (Wilks’ Lambda = .993, F (3, 93) = .205, p = .893, partial eta squared = .007) and the interaction between the two variables over time (Wilks’ Lambda = .962, F (3, 93) = 1.227, p = .304, partial eta squared = .038). Although no statistical significance was found regarding the personal variables, the profile plots revealed interesting findings.

The findings from this study provide implications for nurse administrators, simulation specialists, and nursing faculty to encourage the development of reflection during simulation activities. Future studies should focus on measuring reflection using different samples, and debriefing approaches.