1 / 24

Debriefing in Simulation

Debriefing in Simulation . Garth Meckler, MD, MSHS Mary Anna Gordon, DNP, RN. Overview. Elements Approaches & Styles Methods & Strategies Tips / Tricks / Adjuncts Practice. Is Debriefing Important? History Theory Goals and Objectives Considerations. Is Debriefing Important?.

allie
Download Presentation

Debriefing in Simulation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Debriefing in Simulation Garth Meckler, MD, MSHS Mary Anna Gordon, DNP, RN

  2. Overview Elements Approaches & Styles Methods & Strategies Tips / Tricks / Adjuncts Practice • Is Debriefing Important? • History • Theory • Goals and Objectives • Considerations

  3. Is Debriefing Important? Perceived skill of the debriefer has the highest independent correlation to perceived overal quality of the simulation Wilhelm J. Survey of simulation participants. 1991 • Feedback is the most important feature of simulation-based medical education • Issenberg et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. 2005.

  4. History • Military • After-action review • Aviation • Response to accidents in 1970s • Pre-flight briefings / Post-flight debriefings • Psychology • Experiments using deception • Staff processing

  5. Theory • Andragogy • Adult learning • Malcolm Knowles • Kolb Learning Cycle Experience Simulation Experiment Reflect Translation Debriefing Conceptualize Reflection

  6. Theory • Circumplex Model of Emotion • Russel and Feldman-Barrett Activation Tense Alert Nervous Excited Stressed Elated Upset Happy Unpleasant Pleasant Sad Content Depressed Serene Bored Relaxed Fatigued Calm Deactivation

  7. Goals • Facilitate learning through insight, understanding, and meaning • Safety • Respect • Curiosity • Tied to educational goals of the experience

  8. Objectives • All • Provide a safe, activating environment for learning • Debriefer • Elucidate the thoughts and actions of the participants • Impart critical knowledge, skills, and attitudes • Evaluate the educational experience and strategy • Participants • Improve insight, knowledge, skills, and attitudes • Improve performance performance in similar situations

  9. Considerations • Educational goals and objectives • Learners • Teachers • Time • Timing • Setting

  10. Elements • (Pre-briefing) • Emotions / Reactions (Impact) • Events (Process) • Explanation / analysis (Reflection) • Information (Didactic) • Applicability (Relevance) • Evaluation

  11. Approaches • Three Levels of Debriefing (Dismukes, Aviation Model) • High: participants debrief themselves with minimal guidance • Intermediate: increased instructor involvement in analysis • Low: Intensive instructor involvement

  12. Styles • Judgmental • Goal: Make you to do the right thing • Assumption: I know what went wrong • Approach: blaming, shame, statement of “truth” • Non-judgmental • Goal: Avoid shame • Assumption: as above • Approach: kind, gentle, lead learner to my answer • Carl Rogers: facilitator as catalyst with congruence, acceptance, empathy

  13. Example

  14. Good Judgment • CMS “Good Judgment” • Goal: mutual learning without shame • Assumptions: learner is smart and wants to do the right thing • Mistakes are puzzles, not crimes • Approach: mutual respect, curiosity • Advocacy: first person observation • Inquiry: uncover learner’s frame

  15. CMS Debriefing Process • Reactions Phase • Process emotions • Plus/Delta • Understanding Phase • Explore “Frames” using advocacy/inquiry • Teach through modeling and didactics • Summary Phase • What went well and didn’t • Take home learning points • Real-world application

  16. ExampleEmotions & Plus / Delta

  17. ExampleSummary

  18. Understanding Phase • Learner Frames: • The “minds’-eye” of the learner • Assumptions, feelings, knowledge, awareness, context, goals of the learner Frame Result Action Uncovered Observed

  19. Advocacy-Inquiry • Advocacy: • First person observation of an action or result • Concern or judgment about observation • “I noticed that you left the door to the child’s room open. I am concerned that this might allow humans into our world which could be very dangerous.” • Inquiry: • Question designed to explore learner’s frame • “Clean Question” • “What was on your mind when you walked through that door?”

  20. Practicing Advocacy-Inquiry • Why didn’t you call for help? • You forgot to wear gloves and a face shield, are you trying to get Hepatitis? • I noticed you seemed to get very busy as the code progressed, and I thought you could have used some additional help. I’m wondering where you were on that? • I didn’t see you put on gloves or a face shield. That’s the most common mistake I see in codes like this. I wonder why that happens?

  21. Tips and Tricks for the Difficult Debriefing • Prevention • Pre-brief • Prepare debriefing guides • Work in Teams • Co-facilitator • Body Language • Validate Emotions • Reflective listening • Normalize • Elaborate • Deflect

  22. Additional Strategies / Methods Strategies Methods Collaboration Script Written debriefing Video debriefing • Self debriefing • Peer debriefing

  23. Practice….

  24. Practice…..

More Related