Background: Simulation enhances experiential learning through creating experience to form the basis of learning, and it has been recognized as an effective pedagogy in current health professions education. As an integral element of simulation, debriefing contributes to transforming the created experience to new knowledge. Video-assisted debriefing (VAD) refers to adding audio-visual capture and review to traditional verbal debriefing (VD). Despite being regarded as ‘gold standard’ for simulation, evidence reporting educational effects of VAD is mixed and its best practice remains absent. Aims: The aims of this thesis were to develop a framework for VAD, to test and compare its effects on prelicensure nursing students’ debriefing experiences, reflective abilities and nursing competencies with VD without video, as well as to explore its potential impact on facilitators’ perceptions and practices following high-fidelity simulation. Design and methods: This thesis comprised of four studies with different research designs. Study I was a systematic review which synthesized the characteristics of existing VAD practices in health professions education and evaluated its effectiveness on learners’ reactions, learning and behaviors. Study II was a proof-of-concept study which developed of a three-phase framework for VAD and tested its preliminary effects on nursing students’ debriefing experiences, reflective abilities, and nursing competencies using a pretest-posttest design. Study III adopted a qualitative method to explore nursing students’ experiences and perspectives of a structured VAD using focus groups. Data were analyzed using thematic analysis approach. Study IV employed a mixed-method research design to investigate the impact of a three-phase VAD on nursing students’ debriefing experiences, perceived stress, as well as facilitators’ perceptions and debriefing practices. Results: Study I showed that existing VAD offered comparable educational eff