NURS 617 Week 8 Reflection Paper 2 on Facilitating Simulation Example

Reflection Paper 2: Learning to Stay Quiet, What Facilitating My First Simulations Taught Me About the Educator's Role

Introduction

Before my practicum, I thought the hardest part of simulation would be writing the scenario. It turned out to be keeping my mouth shut. Over the past six weeks, I facilitated three simulations with my preceptor's group of second-semester students and one with new nurse residents. Each taught me something about the educator's role that I could not have learned from reading. This reflection examines three of those sessions, interprets them through recent research, and sets out what I will carry into the next course in the educator track.

The First Simulation: When I Did the Thinking

My first session was the sepsis escalation scenario I planned earlier in the course. The scenario ran well; the students missed early cues, as expected, and escalated late. Then I led the debriefing. My preceptor timed it afterward: in thirty minutes, I spoke for about twenty. I explained the pathophysiology of sepsis, listed the cues they missed and told them what they should have done. The students nodded politely and left with notes but, I suspect, little change in how they would think.

What the Research Suggests

Reading the evidence afterward helped me see what I had done. In the blinded trial by Sahin Karaduman et al. (2025), every debriefing approach helped, yet the two that a trained facilitator steered through a defined structure clearly beat students debriefing themselves, and the meaningful-learning method came out on top. What I had done was neither structured nor learner-centered; it was a lecture held in a debriefing room. A structured method is not a script for the facilitator to perform; it is a discipline that keeps the facilitator from taking over the learners' thinking.

The Second Simulation: The Drifting Observers

For the second session, our lab could fit only two students at the bedside, so four observed through a window. I gave the observers no task. Within ten minutes, two were looking at their phones. In debriefing, the observers had little to say, and the two active students dominated.

What the Research Suggests

I assumed observers simply learn less, but recent evidence suggests otherwise. The review by Amechghal et al. (2026), which pooled fifteen comparisons of watching and doing in health professions simulation, found that most measures of reaction, knowledge, skill and attitude came out about the same for both roles; only the emotional intensity of the experience clearly favored the learners at the bedside. Reading this, I realized that the problem in my second session was not the observer role but my failure to design it. Observers who are engaged with a task can learn as much as participants; observers who are left to watch may not watch at all.

The Third Simulation: Learning to Stay Quiet

By the third session, I made three changes. I gave each observer a cue-tracking sheet. I spent a few minutes with the group the week before, so I was not a stranger on the day. And I committed to Debriefing for Meaningful Learning with my preceptor timing my talk. This time, the debriefing opened with the observers' lists of cues and times, and the students argued, constructively, about when the patient's confusion should have prompted a call. I spoke for about eight minutes of thirty. One student said afterward that they had never thought about the difference between noticing a finding and deciding it mattered. That sentence was worth more to me than any score. It told me the debriefing had reached the thinking behind the actions, which is where I had failed to go in the first session.

What the Research Suggests

The meeting I held the week before mattered more than I expected. Hodge and Kooken (2026) studied 114 medical students and found that the psychological safety learners brought to a simulation predicted their safety and stress afterward, while added safety elements in prebriefing did not. My visit the week before may have done more for the group's willingness to speak than my prebriefing script did. I also learned to expect simulation to change performance more than knowledge. When Park and Chang (2026) compared simulation with lecture for intensive care nurses, knowledge and self-efficacy improved about equally, but clinical performance was much stronger after simulation. In my third session, the change I saw was in how students reasoned and acted, not in what they could recite.

A Fourth Session With New Nurse Residents

My last session was with four first-year nurse residents in the hospital's simulation center, using the opioid-induced respiratory depression scenario from my Simulation Development Plan. Residents brought something students did not: real experience and a reluctance to look uncertain in front of peers. In prebriefing, I noticed two of them glancing at each other when I described the safety agreement, as if they had heard such promises before. During the scenario, the primary nurse recognized the oversedation quickly but hesitated to give naloxone without a direct order, even though the protocol allowed it. In debriefing, I resisted the urge to explain the protocol and instead asked what had made the decision hard. The answer, that a charge nurse had once criticized the resident for giving a protocol medication without calling first, opened the most useful discussion of the week about how unit culture shapes clinical decisions.

That session showed me that simulation with practicing nurses is not simply simulation with more knowledgeable learners. Their hesitations often come from experiences in real units, and debriefing has to make room for those stories without letting them excuse unsafe delays. It also reminded me that the scenario is only as useful as the conversation that follows it.

Feedback From My Preceptor

At the end of the practicum, my preceptor gave me written feedback on my facilitation. The strengths were preparation, clear objectives and, by the third session, patience in debriefing. The area for growth was cueing: during scenarios, I tended to give hints too early when learners stalled, which spared them the discomfort that often drives learning. My preceptor suggested a rule of waiting two full minutes, unless the patient would come to harm, before offering any cue. I plan to use that rule in the next course and to record each time I break it.

What I Have Learned About the Educator's Role

The practicum changed my understanding of the educator's role in three ways. First, the educator's expertise is shown less in what the educator says than in what the educator helps learners discover; my sepsis knowledge mattered most when I used it to choose questions, not to give answers. Second, every learner in a simulation needs a designed role, including observers, because engagement does not happen by default. Third, psychological safety is built slowly and over time, through how the educator treats learners in every encounter, and cannot be installed by a script on the day.

Faith and the Educator's Role

John the Baptist said of Jesus, "He must increase, but I must decrease" (English Standard Version Bible, 2001/2016, John 3:30). The context is very different, but the verse has stayed with me through these weeks. Good facilitation requires the educator to decrease so that the learners' thinking can increase. For a nurse used to being the expert in the room, that is a real discipline, and I have come to see it as a form of humility that serves learners and, through them, their future patients.

Goals for the Next Educator Course

I will carry three goals into the next course. First, I will continue to use one structured debriefing method and ask a colleague to time my talk at least once a month, aiming to keep it under a third of debriefing time. Second, I will design an observer task for every simulation I facilitate. Third, I will build relationships with learners before high-stakes simulations, through brief informal contact, and track learners' anonymous ratings of how safe they felt to think aloud. I will review these goals with my preceptor at the start of the next practicum. Writing them down now, while the three sessions are fresh, should make it harder to slip back into old habits when the next course gets busy.

Conclusion

Three simulations taught me that the hardest skill in facilitation is restraint. Recent research on debriefing, observer roles, psychological safety and simulation outcomes helped me understand why my first sessions fell short and why the third worked better. I finish this course less confident that I know how to teach and more confident that I know how to learn to teach, which seems the right place for an educator to begin.

References

Amechghal, A., Naciri, A., Takhdat, K., Loubbairi, S., Mellouki, A., Lahlou, L., & Nassik, H. (2026). The impact of the learner role in healthcare simulation-based education on learning outcomes: A systematic review. Journal of Educational Evaluation for Health Professions, 23, Article 24. https://doi.org/10.3352/jeehp.2026.23.24

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Hodge, T. J., & Kooken, J. W. (2026). High-fidelity simulation for medical students: Does psychological safety increase during the prebriefing phase? Cureus, 18(7), Article e113533. https://doi.org/10.7759/cureus.113533

Park, J., & Chang, S. J. (2026). Effectiveness of a helmet noninvasive ventilation simulation training: A quasi-experimental study. Nurse Education in Practice, 95, Article 104930. https://doi.org/10.1016/j.nepr.2026.104930

Sahin Karaduman, G., Basak, T., & Duman, S. (2025). Three debriefing methods in virtual patient simulation: A randomized controlled trial. Nurse Education in Practice, 87, Article 104447. https://doi.org/10.1016/j.nepr.2025.104447