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Published on: August 5, 2020
Introducing the Strategic Scripting, Repetitive Practice, Reflection, and Debriefing Model: Evolution of Cognitive
1Boise State University, School of Nursing, Boise, Idaho.
Background:
Incivility in nursing remains a pervasive and complex issue that undermines nurse well-being, team functioning, and patient safety. For two decades, cognitive rehearsal (CR) has served as a foundational evidence-based strategy to help nurses mitigate uncivil behaviors.
Method:
Traditional CR relies on linear, scripted responses and may not fully prepare nurses for the dynamic, unpredictable, and high-stakes nuances of real-world academic and health care work environments. The author reconceptualizes CR as a rigorous, experiential process and introduces scenario-based simulation with strategic scripting, repetitive practice, reflection, and debriefing (S3R2D).
Results:
This framework prioritizes three S pillars: set-up and safety, scenario development with strategic scripting, and simulation as precursors to the two R pillars of repetitive practice and reflection with debriefing.
Conclusion:
S3R2D builds communication competence and emotional regulation through active experiential learning. While leadership must address systemic issues, S3R2D empowers nurses to advocate for a safer, more positive work culture.
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