International Journal of Healthcare Simulation

Background:

Debriefing is a form of ‘‘reflective practice’’ and provides a means of reflection-on-action in the process of continuous learning [1]. Debriefing and feedback have been recognized as the most important aspects of healthcare simulation [2]. It is necessary for simulation, and educators have reported that debriefing increases learners’ knowledge, skill performance, satisfaction, and self-reflection [3]. The ‘Advancing simulation debriefing’ course was delivered in April 2022. The participants were healthcare professionals who had experience in debriefing.

Methods:

The full-day course included reviewing the facilitators’ experience and knowledge of debriefing frameworks and skills, and how these can be adapted and built upon to facilitate more demanding debriefings. During this engaging and interactive course, the attendees were invited to reflect on their own experiences and challenges, and build on active involvement in practising these skills live via tailored exercises. Participants were asked to complete a pre-course and post-course questionnaire rating their knowledge, confidence, and attitudes towards debriefing skills. The learning objectives covered a range of skills, such as learning different strategies for uncovering biases within debriefings and how to address these, how to maintain core psychological safety through challenging debriefings, and how psychologically informed debriefing principles, can enhance debriefing practice, for scenarios with a mental health focus as well as many others. Ethical approval was given by the Psychiatry Nursing and Midwifery Research Ethics Subcommittee at King’s College London (PNM 13/14–179).

Results:

Paired samples t-tests were conducted to analyze the difference in ratings between the pre-and post-course questionnaires. Of the 18 participants within the course, 11 provided eligible responses. They were healthcare professionals who were regularly involved in simulation-based education and debriefing. Results demonstrated a significant difference in the scores for all course-specific questions between pre- and post-score answers (pre-course MD=70.81, SD=9.24, post-course MD=96.82, SD=6.35) t(10) test=-7.41, p<0.0001, with an average increase of 37% in the total score. Open-text responses reflected improved confidence in the usage of different debriefing models, considering emotional factors, and taking the lead while debriefing.

Conclusion:

The course had an impact on improving debriefing skills, especially by improving the facilitators’ confidence in debriefing skills, ability to debrief, and understanding of how debriefing is related to simulation-based learning. These results demonstrate a profound benefit of the use of advanced debriefing skills as a better way to standardize participant experience across different sites to improve healthcare practice.

References

1. Sawyer T, Eppich W, Brett-Fleegler M, Grant V, Cheng A. More Than One Way to Debrief. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2016;11(3):209–217.

2. Voyer S, Hatala R. Debriefing and Feedback. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare. 2015;10(2):67–68

3. Kim Y, Yoo J. The utilization of debriefing for simulation in healthcare: A literature review. Nurse Education in Practice. 2020;43:102698.