目的 了解护理院校及临床医院护理教师实施引导性反馈的现况,并分析其影响因素。方法 基于国际护理临床模拟教学协会的模拟最佳实践标准及医疗模拟引导性反馈评估量表等引导性反馈评估工具编制问卷。采用方便抽样,对护理院校及临床医院的133名参与过护理模拟教学中引导性反馈实践的教师进行调查。结果 34名（25.6%）的教师认为自己胜任引导性反馈。教师实施引导性反馈遇到困难较多的有“有的学员说得太少,沉默不言”（72.9%）、“让学员积极参与到引导性反馈中”（67.7%）、“学员没有提前准备好（材料、作业任务、技能练习等）”（63.9%）。引导性反馈实施质量问卷得分为1~22（14.32±4.45）分,其中条目“在模拟案例运行时记录学员个人或团队的表现”正确率最高,为96.2%;条目“在模拟案例运行前向学员介绍引导性反馈的安排及目标”正确率最低,为38.3%。多元线性回归分析显示,年龄（β=-0.293）、开展引导性反馈的年限（β=0.177）、对INACSL模拟最佳实践标准的熟悉程度（β=0.341）、参与护理教学时间（β=0.197）和参加过相关培训（β=0.254）是引导性反馈实施质量的影响因素（调整R²=0.388,F=14.933,P<0.001）。 结论 护理教师引导性反馈实施质量有待提升,引导性反馈培训不足,面临学员参与度不足的挑战。应依据模拟最佳实践标准加强教师培训,以提升引导性反馈实施质量。

Objective To investigate the current status of debriefing used in simulation teaching by nursing colleges and clinical teachers in China,and to analyze the influencing factors. Methods Questionnaires were developed based on INACSL simulation best practice standards and Debriefing Assessment for Simulation in Healthcare,etc. By convenience sampling,133 nursing teachers from nursing schools and clinical hospitals who had experience of debriefing in nursing simulation teaching were investigated. Results Thirty-four nursing teachers（25.6%）thought they were competent in debriefing. Nursing teachers encountered more difficulties in implementing debriefing and these difficulties included “some students talked too little or kept silent”（72.9%）,“making students actively participate in debriefing”（67.7%）,and “students did not prepare for the class in advance（materials,assignments,skill exercises,etc.）”（63.9%）. The score of the questionnaire on implementation quality of debriefing ranged from 1 to 22（14.32±4.45）. The item “recording the performance of student or team during the scenario” had the highest accuracy rate（96.2%）.The item “introducing the arrangement and objectives of debriefing to students before running the scenario” had the lowest accuracy rate of 38.3%. Multiple linear regression analysis showed that age（β=-0.293）,time to conduct debriefing（β=0.177）,familiarity with INACSL simulation best practice standards（β=0.341）,time of participating in nursing teaching（β=0.197）and participation in training（β=0.254）were the influencing factors of the quality of debriefing implementation（Adjusted R²=0.388,F=14.933,P<0.001）. Conclusion The quality of debriefing practices needs to be improved. Nursing teachers have insufficient debriefing training and face the challenges of insufficient participation of students. Specific training should be strengthened based on simulation best practice standards to improve the quality of debriefing practices.