To date, many of the methods used in clinical simulation have focused primarily on assessing technical skills and compliance with medical standards, often from a generic, interprofessional perspective. Although technical skills are essential, this approach overlooked key aspects of nursing practice, such as care ethics, relational presence with patients and emotional management among nurses.
To address this, a team of researchers has developed Power in Practice, a new debriefing framework that transforms how nursing simulation sessions are analysed. Published in the scientific journal Clinical Simulation in Nursing, this model shows that encouraging reflective dialogue about how practitioners feel and the impact of their decisions significantly improves their psychological safety and helps ensure that their voices and leadership are recognized within the healthcare system. The research team included Clara Selva Olid, a researcher with the Behavioural Design Lab (BDLab), affiliated with the eHealth Centre, and was led by Laura Macià Casòliva, from Althaia, in collaboration with Carlota Riera Claret, from UVic-UCC.
Four stages for transforming learning
The model proposes redefining debriefing as a structured, four-stage sequence aimed at optimizing learning. The first stage, Feel, focuses on emotions and psychological safety; the second, Think, on clinical reasoning and nursing knowledge; the third, See, on recognizing of the impact of professional actions; and the fourth, Move, on translating insights into concrete actions that can inform future practice.
Debriefings are structured, reflective conversations held after a simulation or clinical situation to analyse the experience, understand the decisions amde and transform them into learning. The new framework builds on existing approaches by making nurse empowerment one of the key aims of the reflective practice. With this model, practitioners are invited to explore the emotions they experience, reflect on their clinical reasoning, recognize the impact of their actions and identify concrete actions to help improve future practice.
A model grounded in qualitative research
The study underpinning the development of this tool involved an in-depth analysis of nurses' real-life experiences during the first wave of the COVID-19 pandemic and during simulation-based education. The findings highlighted several factors linked to nurse empowerment, including psychological safety, positive team climate, confidence, autonomy, reflection and recognition of the impact of nursing practice. Applying the model not only supports the development of clinical skills but also fosters adaptability, professional self-awareness and autonomy, qualities that are essential for working in highly complex healthcare settings.
The publication makes a major contribution to the field of clinical simulation in nursing by framing debriefing not only as a means of reviewing practice, but also as an opportunity to strengthen nurses' identity, confidence and capacity to act.
The model can be used in both clinical simulation and complex healthcare situations, as well as in mentoring and team reflection processes. Nevertheless, the study highlights the need for further research to evaluate the model's effectiveness in different settings.