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This dissertation, A Cluster Randomized Controlled Trial of Using Structured Debriefing to Enhance Knowledge Retention in Nurses Undergoing Simulation-based Resuscitation Training by Chun-kit, Jacky, Chan, 陳俊傑, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: The competency retention rate of Advanced Cardiac Life Support (ACLS) among nurses was poor. The knowledge retention rate among those who have completed an ACLS course rapidly declined to 37% at three months, and 14% at one year. Extending the course duration did not show any improvement in the retention rate. Structured debriefing may be a possible solution, but its efficacy on knowledge retention among nurses has not been examined. The aims of this thesis are to perform linguistic and psychometric evaluation of a Chinese version of Student Satisfaction and Self-confidence (SSSC), and to assess the effects in knowledge retention of nurses in a simulation-based resuscitation training, using the Gather-Analysis- Summary (GAS) model of structured debriefing. In this thesis, the reliability and scale structure of the Chinese SSSC were assessed in 161 nurses when they attended an ACLS course. Confirmatory factor analysis showed that a two-factor structure had satisfactory with χ DEGREES2 = 92.12 (df = 54), RMSEA = .07 (90% CI = .04 to .09), CFI = .98 and NNFI = 0.96. The two factors are the satisfaction and self-confidence which had high internal reliability with Cronbach's alpha as .95 and .97, respectively. The Chinese SSSC is a reliable and valid tool to assess student satisfaction and self-confidence in simulation training. A cluster randomized controlled trial (RCT) was conducted to assess the efficacy of the GAS model. The primary outcome in this study was knowledge competency. It was assessed by the written test of the American Heart Association ACLS provider course. The secondary outcomes in this study were perceived skills, and self-efficacy. They were assessed using our validated Chinese SSSC and the General Self-Efficacy scale. In the intervention arm, the instructor conducted 18 scenarios and structured debriefing using the GAS model. Each GAS model of debriefing session consisted of three phases, namely: Gather, Analysis, and Summary. The debriefing session was conducted to help participants to self-reflect on the learning objectives. Each debriefing session lasted about 5 to 10 minutes. In the control arm, participants had 36 scenario as usual teaching plan instead of debriefing at the end of each scenario. A follow-up assessment were conducted at Day Two and Week 24. A total of 161 nurses were recruited in this study. They were divided into 32 groups and randomized by groups to either the intervention arm (n=85, 15 groups) or the control arm (n=76, 17 groups). The effects of the GAS model were examined using a linear mixed effects model to take account of the extra-covariance among participants in the same group. The test showed that the GAS model debriefing improved knowledge retention after Day Two follow-up. However, it was marginally significant (estimated coefficient= 2.56, 95% CI= .17 to 4.95, d=.22, p=.036). Perceived skills (estimated coefficient=.01, 95% CI= -.24 to. 27, d=.15, p=.918), and self-efficacy (estimated coefficient= -.01 95% CI= -1.27 to 1.24, d=.06, p=.984) were also not significant. After adjusting the baseline by adding three significant different baseline factor, namely: education level, rank, and prior ACLS certification, the knowledge (estimated coefficient=1.54, 95% CI=-1.06 to 4.16, d=.22, p=.242). Perceived skills (estimated coeffi

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