Between simulation and debriefing: Instructors’ collaborative interpretation of student performance in nurse care training

Abstract Simulation-based education is valuable as it creates contexts where instructors can analyse student learning in a performative sense. Investigating video records of simulation exercises, instructor teams collaboratively interpret and evaluate how students perform professional tasks, and the teams decide what to highlight in the upcoming debriefing. This study investigates how clinical experts, such as experienced teams of operators and facilitators, collaboratively analyse, interpret and judge nursing student actions during intensive care training. To our knowledge, very few studies focus on the pedagogical significance of researching how instructor expertise and professional judgement develop in simulation-based education. The analysis is based on 30 ( n = 15 h) video-recorded conversations between operators and facilitators in two control rooms at a Nordic undergraduate nursing training center. The results show how instructors continuously evaluate how, and to what extent, students’ clinical actions demonstrate progress toward learning goals and professional standards. The kind of professional vision emerging among instructor teams involves not only monitoring whether students' actions are performed correctly but also collaboratively considering whether these actions are contextualized within professionally relevant care procedures. It is argued that instructors’ collaborative interpretations are consequential for 1) continuously developing their expertise to interpret learners’ actions, and 2) their ability to point to relevant features of the simulation that can be used to shape students’ reflective engagement during the debriefing phase. The study contributes with analyses of how instructors’ collaborative expertise evolves when it comes to identifying and conceptualizing challenges students encounter while learning clinical practices.