2026 Theses Doctoral

Effect of the Trauma-Informed Psychologically Safe Debriefing Method on Coping Skills and Debriefing Experience in Nursing Students: A Quasi-Experimental Study

Wentzel, Jennifer Anne

Caring for patients at the end of life is an essential nursing role. However, nursing students often report feeling unprepared to care for dying patients due to inadequate education.

Simulation is an established and effective method for knowledge and skill acquisition, but its impact on psychological outcomes remains unclear. While debriefing is an essential aspect of simulation, no method has been shown to be more effective than others. Additionally, equivalent learning outcomes have been demonstrated between active participants and observers; however, parity in psychological outcomes remains unknown. Guided by the Transactional Model of Stress and Coping, the purpose of this dissertation was to examine differences in coping skills and participants' experiences among undergraduate nursing students who debriefed using either the Trauma-informed Psychologically Safe (TiPS) debriefing method or a traditional debriefing method after actively participating in or observing an end-of-life simulation.

This study was a quasi-experimental, two-group, pretest-posttest design with a non equivalent comparison group. A convenience sample of 145 undergraduate nursing students in traditional Bachelor of Science in Nursing programs was recruited from two universities in the United States. Students either actively participated (n = 60) or observed (n = 85) an end-of-life simulation and then debriefed using either the TiPS debriefing method (n = 69) or the Plus-Delta debriefing method (n = 70). Data were collected before the simulation and following the debriefing using the Coping with Death Scale-Short Version, whereas the Debriefing Experience Scale was administered only following the debriefing.

An analysis of the results revealed participants in all groups had significantly higher coping with death scores after the intervention (p < .05). However, participants in the TiPS group reported significantly higher coping with death scores (p = .046) and more positive debriefing experiences (p < .001) than those in the Plus-Delta group. There were no differences in coping with death or debriefing experience between active participants and observers.

Findings suggest that structured debriefing can enhance psychological outcomes regardless of participant role. This flexibility allows simulation programs to optimize resources by meaningfully incorporating observers across all types of simulation-based education. In this study, the TiPS debriefing approach proved effective in fostering psychological outcomes among undergraduate nursing students after an end-of-life simulation. Future research should address how specific debriefing methods impact robust outcomes and further explore the impact of participant role on coping with death.