THE ROLE OF PRE-BRIEFING OF SIMULATION-BASED EDUCATION ON THE STUDENTS’ PERCEPTION OF PSYCHOLOGICAL SAFETY: A REPEATED MEASURE DESIGN

Abstract

BackgroundPsychological safety (PS) plays a critical role in simulation-based education (SBE), influencing students’ learning, engagement, and satisfaction. PS allows learners to take interpersonal risks such as asking questions, admitting mistakes, or participating fully, without fear of embarrassment or judgment. The study examined the effect of structured pre-briefing on students’ perception of PS. Guided by Amy Edmondson’s Team Learning Model, the study also examined predictors of PS and the mediating role of PS in the relationship between pre-briefing and learning outcomes. Methods A repeated measures design was employed among undergraduate nursing students (N = 153) across three time points: pre-briefing, post-pre-briefing, and post-simulation. A structured pre-briefing guided by the International Nursing Association for Clinical Simulation and Learning standards for best practice (INACSL) and NLN prebriefing guidelines was implemented. Results The Friedman test revealed a significant difference in psychological safety scores across the three time points, pre-simulation, post-pre-briefing, and post-simulation (χ² (2) = 86.94, p < .001), with an improvement observed after the pre-briefing and post-simulation. Multiple regression analysis revealed that Context Support (β = 0.191), Faculty Coaching (β = 0.205), and Team Learning Behavior (β = 0.239) were significant predictors of the value of PS. Mediation analysis showed that PS partially mediated the relation between pre-briefing and both team learning behavior (indirect effect = 0.19, 95% CI [0.10, 0.32]) and simulation satisfaction (indirect effect = 0.15, 95% CI [0.07, 0.27]). Conclusion Structured prebriefing and faculty behaviors play a critical role in shaping students’ psychological safety during simulation. By fostering a safe learning environment, educators can positively influence team learning and satisfaction outcomes. Integrating evidence-based pre-briefing practices and faculty development focused on coaching and support may significantly enhance the effectiveness of SBE.