debrief basics: debrief research for novice educators · debrief basics: debrief research for...
TRANSCRIPT
Debrief Basics:
Debrief research for novice educators IMSH 2019, Texas
Ranjev Kainth
Colette Laws-Chapman
Gabriel Reedy
Libby Thomas
Acknowledgements to Dr Peter Jaye
Simulation & Interactive Learning Centre (SaIL), London, UK
King’s College London, London, UK
• To gain an understanding of the different approaches to
debrief research
• Describe research on debrief practice
• Describe quantitative research in relation to:
– Debrief vs non-debrief
– Scripted debrief
– Video use in debrief
• Insitu debrief
• Describe three qualitative pieces of debrief research
Workshop AimsSession Aims
Sawyer, T., et al. (2016).
More Than One Way to Debrief: A
Critical Review of Healthcare
Simulation Debriefing Methods
Simul Healthc 11(3): 209-217
Debriefing methods:
1.Facilitator guided post-event3-phase or multi-phase
2.Self-guided post-event debriefing
3.Facilitator guided within event debriefing
Research
on Debrief
Practice
How is debrief conducted?
Sawyer, T., et al. (2016).
More Than One Way to Debrief: A
Critical Review of Healthcare
Simulation Debriefing Methods
Simul Healthc 11(3): 209-217
• [Seven] Essential elements for effective debriefing:
– Psychological safety
– Basic assumption
– Debriefing rules
– Shared mental model [of scenario events]
– Address learning objectives
– Opened ended questions
– Silence
• Conversational Techniques
– Style of questioning
• Debriefing Adjuncts:
– Co-debriefing
– Use of video
– Debriefing script
Research
on Debrief
Practice
How is debrief conducted?
Debrief process elements
Tannenbaum, S. I. and C. P. Cerasoli (2013)
Do team and individual debriefs enhance
performance? A meta-analysis.
Hum Factors 55(1): 231-245.
Meta-analysis
Outcome: performance
• 25% Improved effectiveness overall
• Facilitated > non-facilitated
Debrief
Research:
Outcomes
How effective is debrief?
2013
Cheng, A., et al. (2014).
Debriefing for technology-enhanced
simulation: a systematic review and meta-
analysis.
Med Educ 48(7): 657-666.
Meta-analysis (108 studies)
“favourable and statistically significant effects for nearly all
outcomes“
Debrief
Research:
Outcomes
How effective is debrief?
2014
Cheng, A., et al. (2013)
Examining pediatric resuscitation education
using simulation and scripted debriefing: a
multicenter randomized trial.
JAMA Pediatr 167(6): 528-536.
Prospective, randomized,
factorial study design
• 14 simulation programmes
(~400 participants)
• Outcomes: MCQ, BAT, CPT
• Scripted: MCQ+BAT
• Physical realism/fidelity – no
correlation to outcomes
Debrief
Research:
Outcomes
Scripted
Physical Realism
(Savoldelli et al. 2006, Sawyer et al. 2012,
Tannenbaum et al. 2013 Cheng et al. 2014)
Equivocal:
Meta-analysis have not shown
any significant difference
between video-assisted
debriefing compared to oral
debriefing
Debrief
Research:
Outcomes
Video Vs. No Video
• Patterson (2013) identify latent errors (surfaced in the debrief)
• Bender (2011) Test new clinical environments
• Goldhaber-Fiebert (2015), Abrahamson (2006)
– Checklists such as blood transfusion, administration of drugs or
implementation of protocols may identify errors through debriefing
insitu
Debrief
evidence
Factors associated with Learning:• Safe Environment
• Debriefing to Explore Thoughts
• Feedback from Multiple Perspectives
• All in This Together
• Group FacilitationFey, M. K., et al. (2014).
Learning Through Debriefing: Students' Perspectives
Clinical Simulation in Nursing 10(5): e249-e256.
Ulmer et al. (2018)
Cultural prototypes and differences in
simulation debriefing. Sim Healthcare
• Examined power
distance and debrief
practice
• Interviews with debriefs
regarding debrief
practice
Ulmer et al. (2018)
Cultural prototypes and differences in
simulation debriefing. Sim Healthcare
• Low PDI
– Facilitators talked less
– Focus on and easier to discuss NTS
– Interactions initiated by participants more
– Increased perceived group interactions
Summary
• Debrief follows a clear structure; questioning differs
• Evidence that debrief improves outcomes
– Scripted, facilitator-led – improved effectiveness
– Physical fidelity, video – equivocal evidence
• Debrief practice is not homogenous
– Core features which facilitate learning
– Different interaction patterns, different factors at play
Questions?
Twitter: @huMANikin
Facebook: www.facebook.com/SAILcentreatGSTT
Website: www.guysandstthomaseducation.com/project/simulation/