Simulcast Journal Club is a monthly series inspired by the ALiEM MEdIC Series. It aims to encourage simulation educators to explore and learn from publications on healthcare simulation. Each month we will publish a case and link a paper with associated questions for discussion. We will moderate and summarise the discussion at the end of the month, including exploring the opinions of experts from the field.
Simulcast Journal Club August 2016 – “Debriefer Knows Best”
The Case :
Cath was sitting enthralled in the SIM control room watching a heated argument occurring through the glass in front of her. All told it had been a fairly tumultuous sim with the team making a number of surprising decisions.
Despite the critical hypotension and positive FAST scan, the group had elected to take the patient to CT to find the source of his intra-abdominal bleeding. The airway doctor Dale had also nearly come to blows with the drugs nurse Madge.
As the case was going to wrap up soon, Cath began to map out her main discussion points for the debrief. It was a shame she only had 20 minutes, there was so much to talk about. “I need to address the decision to go to the CT. That patient could have died.” thought Cath. “Then I’ll acknowledge that blow up with Madge and Dale. If they can’t communicate honestly with each other, there could be huge repercussions for the patient.”
With her priorities arranged, Cath rushed to the debriefing room to catch the participants as they walked out.
“I can’t believe I didn’t call a trauma respond!” whispered Dale to his fellow resident. “I don’t even know how to activate it here. What if I get a trauma on nights?”
Cath’s heart sank a little, there was no way she was going to have time to address the trauma respond issue, she’d already identified more critical issues that the learners really needed to hear about. Besides, she thought a little guiltily, Dale failing to call the trauma respond was the least of his problems. With a deep breath Cath turned to the group:
“So,” she said, “How did that feel?”.
The Article :
“Learner-Centered Debriefing for Health Care Simulation Education”
As passionate instructors we often have strong opinions on what our learners ‘Need to Know’. Simulation participants, on the other hand, may have an entirely different set of learning objectives that they have identified while being in the scenario. In this month’s article from Simulation in Healthcare, Cheng et al explore the continuum of teaching styles between ‘Learner Centred Debriefing’ and ‘Instructor Centred Debriefing’. In doing so they advocate for a more Learner Centred approach to debriefing, while still acknowledging that there are benefits to an Instructor Centred approach in certain circumstances.
Please comment below on your thoughts and reflections on the article.
- Where do you think you sit on the continuum between Learner and Instructor Centered Debriefing? Has reading this article changed your stance?
- Do you find it challenging to relinquish control of the learning objectives to your learners?
- Conversely, it may be difficult for some Learners to share responsibility for the debriefing outcomes! What strategies have you found useful to assist you in collaborating with your learners in the Simulation setting?
- As clinicians, it can be hard to learn to critique an educational paper like this. What are your thoughts about the structure and methods of this article?
Cheng, A., Morse, K. J., Rudolph, J., Arab, A. A., Runnacles, J., & Eppich, W. (2016). Learner-Centered Debriefing for Health Care Simulation Education: Lessons for Faculty Development. Simulation In Healthcare: Journal Of The Society For Simulation In Healthcare, 11(1), 32-40. doi:10.1097/SIH.0000000000000136