The impact of a high fidelity simulation-based debriefing course on the Debriefing Assessment for Simulation in Healthcare (DASH)© score of novice instructors

Abstract

Introduction: Experiential learning, followed by debriefing, isat the heart of Simulation-Based Medical Education (SBME) andhas been proven effective to help master several medical skills.We investigated the impact of an educational intervention, basedon high-fidelity SBME, on the debriefing competence of novicesimulation instructors.Methods: This is a prospective, randomized, quasi-experimental,pre- and post-test study. Sixty physicians without prior formaldebriefing expertise attended a 5-day SBME seminar targeted ondebriefing. Prior to the start of the seminar, 15 randomly chosenparticipants had to debrief a spaghetti and tape team exercise.Thereafter, the members of each team assessed their debriefer’sperformance using the Debriefing Assessment for Simulation inHealthcare (DASH)© score. The debriefing seminar that followed(intervention) consisted of 5 days of teaching that included theoreticaland simulation training. Each scenario was followed by a Debriefingof the Debriefing (DOD) session conducted by the expert instructor.At the end of the course, 15 randomly chosen debriefers had todebrief a second tower building exercise and were re-evaluated withthe DASH score by their respective team members. The Wilcoxonsigned-rank test was used to compare pre- and post-test scores.Statistical tests were performed using GraphPad Prism 6.0c for Mac.Results: A significant improvement in all items of the DASH scorewas noted following the seminar. The debriefers significantly improvedtheir performance with regard to “maintaining an engaging learningenvironment” (Median [IQR]) (4[3-5] after the pre-test vs. 5.5[5-6]after the post-test, Pway” (5[4-5] after the pre-test vs. 5[5-6] after the post-test, p=0.002);“provoking engaging discussion” (4[3-5.75] after the pre-test vs. 6[5-6]after the post-test, Pgaps” (5[4-6] after the pre-test vs. 6[5-6] after the post-test, P=0.014);and “helping trainees to achieve and sustain good future performance”(4[3-5] after the pre-test vs. 6[5-6] after the post-test, PConclusion: A simulation-based debriefing course, based mainlyon DOD sessions, allowed novice simulation instructors to improvetheir overall debriefing skills including, more specifically, the abilityto foster engagement in discussions and maintain an engaginglearning environment.

Keywords

• faculty
• learning
• feedback