| Sumario: | Supplemental Digital Content is Available in the Text. Introduction.: To better support the development of domain expertise, there has been considerable interest in the instructional strategies that afford opportunities for problem solving. Simulation-based learning includes case-based activities that support learners' transition into practice through experience and reflective debriefing. Review of the Literature.: Simulation-based learning serves as a means for learners to practice psychomotor, affective, and cognitive skills. Although the literature suggests this is an effective strategy for supporting problem-solving skills, much of the literature is focused on measuring cognitive outcomes within a single case. As such, very few studies have simultaneously investigated (a) how debriefing in simulation-based education supports problem solving and (b) the degree to which cognitive and affective learning outcomes are variable throughout the problem-solving process. Methodology.: To address this gap, this repeated-measures study examined the role of debriefing strategies in simulation-based learning experiences, which was designed to practice both cognitive and affective skills. In the control condition, participants were given 2 simulation-based laboratory instructional sessions and then assessed on cognitive (problem representation and solution generation) and affective learning (perceived self-efficacy) outcomes. In the comparison condition, participants engaged in debriefing sessions after each of the 2 simulation-based laboratory instructional sessions. For the cognitive outcomes, participants were assessed using the Think-Aloud Standardized Patient Examination instrument, which measured problem representation and solution generation. Acute care confidence survey was used to measure perceived self-efficacy. Results.: The study found statistically significant gaps in early-stage measures of cognitive problem representation, but no difference was found in solution generation or perceived self-efficacy measures. Conclusion.: This study reinforces the importance of debriefing in simulation-based education. Specifically, this study suggests that cognitive learning outcomes are variable during the problem-solving process, but affective learning outcomes are more fixed and may need more targeted debriefing.
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