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Cognitive control level of action for analyzing verbal reports in educative clinical simulation situations

Abstract : Background: Several methods and theoretical frameworks have been proposed for efficient debriefing after clinical simulation sessions. In these studies, however, the cognitive processes underlying the debriefing stage are not directly addressed. Cognitive control constitutes a conceptual link between behavior and reflection on behavior to apprehend debriefing cognitively. Objectives: Our goal was to analyze cognitive control from verbal reports using the Skill-Rule-Knowledge model. This model considers different cognitive control levels from skill-based to rule-based and knowledge-based control. Design: An experiment was conducted with teams of nursing students who were confronted with emergency scenarios during high-fidelity simulation sessions. Settings: Participants' descriptions of their actions were asked in the course of the simulation scenarios or during the debriefing stage. Participants: 52 nursing students working in 26 pairs participated in this study. Methods: Participants were divided into twogroups: an “in situ” group inwhich they had to describe their actions at different moments of a deteriorating patient scenario, and a “debriefing” group, in which, at the same moments, they had to describe their actions displayed on a video recording. In addition to a cognitive analysis, the teams' clinical performance was measured. Results: The cognitive control level in the debriefing group was generally higher than in the in situ group. Good team performance was associated with a high level of cognitive control after a patient's significant state deterioration. Conclusions: These findings are in conformity with the “Skill-Rule-Knowledge” model. The debriefing stage allows a deeper reflection on action comparedwith the in situ condition. If an abnormal event occurs as an adverse event, then participants' mental processes tend to migrate towards knowledge-based control. This migration particularly concerns students with the best clinical performance. Thus, this cognitive framework can help to strengthen the analysis of verbal reports.
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https://hal.univ-rennes2.fr/hal-01960460
Contributor : Laurence Leroux <>
Submitted on : Wednesday, December 19, 2018 - 2:07:36 PM
Last modification on : Tuesday, June 11, 2019 - 3:42:03 PM

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  • HAL Id : hal-01960460, version 1

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Thierry Morineau, Sébastien Meineri, Pascal Chapelain. Cognitive control level of action for analyzing verbal reports in educative clinical simulation situations. Nurse Education Today, Elsevier, 2017, 50, pp.104-108. ⟨hal-01960460⟩

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