1Faculty of Nursing, Jordan University of Science and Technology, Jordan 2Department of Legal Medicine, Toxicology and Forensic Medicine, Jordan University of Science and Technology, Jordan 3Faculty of Pharmacy, Jordan University of Science and Technology, Jordan
Background: Using simulations as the platform of education for nursing interns, those interns become capable of recognizing and managing clinical deterioration. The post-experience discussion contributes hugely to value Students who fear embarrassment, judgment of punishment, or harm to their professional credibility will hide their uncertainty and participate defensively to limit the reflective processes through which clinical reasoning develops.
Objective: This study aims to determine if a standardized psychologically safe simulation and debriefing intervention improves clinical decision-making self-efficacy and observer-rated clinical judgment of the nursing intern. It will also examine whether psychological safety and active reflective engagement account for such improvements.
Methods: A two-arm, assessor-blinded, cluster-randomized controlled trial with approximately 240 final-year nursing interns, from a university-based nursing program in Jordan. 24 intact simulation groups were created, with an average of 10 participants per group. Groups were randomized 1:1 to the intervention or active-comparison condition. The same realistic simulation will be carried out by both groups. The planned actions incorporated a standardized safe-container prebriefing, a non-punitive language of the facilitator, advocacy-inquiry, balanced participation, error normalization with clinical standards specification and structured reflective synthesis. The comparison group received the usual care debriefing of equivalent duration.
Results: The main outcome was clinical decision-making self-efficacy, which was measured at baseline, post-debrief, and 6 weeks. Perceived psychological safety, anxiety, active reflective engagement and observer-rated clinical judgement were secondary outcomes. Estimates of group-by-time effects was fitted using linear mixed-effects models taking into account repeated observations and clustering. Secondary analyses examined calibration of confidence and performance, multilevel mediation, and facilitator competence moderation.
Conclusion: The research evaluated whether psychological safety functions as an educational mechanism rather than as a more general indicator of student satisfaction. Combining self-efficacy with unbiased evaluation of clinical judgment addressed the issue of patient-safety whereby confidence increases but competence does not. Results may inform debriefing standards, faculty development, and transition-to-practice education.
Keywords: Clinical Decision-Making; Clinical Judgment; Debriefing; Nursing Interns; Psychological Safety; Simulation-Based Education; Self-Efficacy
Ahed J Alkhatib., et al. “Effect of a Psychologically Safe Simulation and Debriefing Intervention on Clinical Decision-Making Self- Efficacy and Clinical Judgment among Nursing Interns Protocol for a Cluster-Randomized Controlled Trial”. EC Gynaecology 15.10 (2026): 01-16.
© 2026 Ahed J Alkhatib., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Open Access by ECronicon is
licensed under a Creative Commons Attribution
4.0 International License
Based on a work at www.ecronicon.net
