International Journal of Healthcare Simulation

Background:

Immersive simulation is an expensive education modality with a high faculty requirement, for which its cost effectiveness can come under scrutiny [1]. Physical distancing during the COVID-19 pandemic necessitated decreased participant numbers on simulation courses, leading to significant training implications including an onus on remote learning [2]. We postulated a novel approach to increase course capacity, while maintaining quality, would be to facilitate a ‘double debriefing’. When compared with other strategies, such as online simulation or a hybrid model, this approach could improve effectiveness and engagement, which can be challenging with a ‘remote’ group of participants.

Methods:

Two simulation days, involving 28 foundation doctors, were chosen for the pilot study. Participants were randomly allocated to one of two debriefing rooms. Simulations were completed in pairs, with one participant from each room. Following the simulation, the participants returned to their respective debriefing rooms. The debriefing structure was standardised across both rooms through a 3-phase model (Description, Analysis, and Application) with clearly defined learning objectives. Debriefing facilitators rotated between each room. A post-course questionnaire was used to collect qualitative and quantitative data. Five questions explored: Overall course rating; positive aspects of the course; areas for improvement; perceptions of double debriefing; and comparison to previous foundation simulation days. The qualitative data then underwent thematic analysis.

Results:

All participants rated the courses as excellent or very good (17 and 11 respectively). 19 participants agreed or strongly agreed that double debriefing worked well. 5 neither agreed nor disagreed, 1 disagreed, and 3 did not answer. When compared to previous foundation simulation days, 14 participants stated the experience was better, 9 thought it was equivalent, 1 thought it was worse, 2 did not answer, and 2 had not previously attended. Smaller debriefing groups were seen as a positive, however participants also wanted a smaller overall group size to ensure everyone had the opportunity to participate in a simulation.

Conclusion:

A ‘double debrief’ approach to Foundation doctor simulation training is perceived as an acceptable and potentially desirable method to increase course capacity whilst controlling group sizes. This has implications for both increasing access to simulation-based education, but also in delivering more high-quality simulation-based education at minimally increased cost. Moreover, this could enhance the delivery of interprofessional simulation, which often involves larger groups [3]. Larger studies involving more diverse groups of healthcare professionals will be conducted to ascertain wider applicability.

References

1. Maloney S, Haines T. Issues of cost-benefit and cost-effectiveness for simulation in health professions education. Advances in Simulation. 2016;1(1):1–6.

2. Freer H, Jones S, Lewandowski, J, Randles D, Dores C. 138 Student Perspectives of a Novel Remote Simulation Course. International Journal of Healthcare Simulation. 2021. 1: Supplement 1. A60-A60.

3. Holmes C, Mellanby E. Debriefing strategies for interprofessional simulation – a qualitative study. Advances in Simulation. 2022;7(1):1–9.