Simulation With Debriefing and Guided Reflective Journaling to Stimulate Critical Thinking in Prelicensure Baccalaureate Degree Nursing Students.

Background: Simulation and guided reflective journaling have been identified as effective teaching and learning methods to develop critical thinking (CT) and clinical reasoning skills in nursing students. Method: A descriptive correlational design was used to determine the relationship between CT and level of reflection using the Holistic Critical Thinking Skills Rubric (HCTSR) and the level of reflection on action assessment (LORAA), respectively, to evaluate 23 baccalaureate student-guided reflective journal entries after a simulation exercise with guided debriefing and after two subsequent clinical experiences. Results: A statistically significant positive relationship (p < .01) was found between mean HCTSR and LORAA scores on all three journal entries, but no relationship to CT during simulation or on standardized test scores. The results also indicated support for use of the guided reflection after significant learning experiences. Conclusions: The LORAA and the HCTSR are effective measures of level of reflection and CT to evaluate learning from simulation and clinical experiences.