Debriefing Techniques Utilized in Medical Simulation

Excerpt

Simulation-based education (SBE), when used under the right conditions, correlates with significant effects on knowledge, skills, and behaviors and moderate effects for patient-related outcomes. Post simulation debriefing is one of the most effective components of SBE and the cornerstone of the learning experience in the medical simulation setting. Debriefing is the intentional discussion following the simulation experience that allows participants to gain a clear understanding of their actions and thoughts process to promote learning outcomes and enhance future clinical performance. It allows faculty and learners to reexamine the simulated case experience, share their mental model, and foster the reasoning behind their clinical judgment. Kolb’s experiential learning cycle involves a concrete experience—simulation, followed by observation and reflection on that experience through debriefing. Experiential learning theory suggests that this leads to the formation of abstract concepts and generalizations, which are then used to test the hypothesis in future situations, resulting in subsequent new concrete experiences. The reflective process of debriefing is a cornerstone of the experiential learning theory.

Training facilitators in debriefing techniques is critical to ensure effective debriefing among simulation faculty. Historically, the provision of formal debriefing training has been through a variety of faculty development programs that include simulation instructor training courses, conference-associated workshops, textbook readings, and online modules. Recently several advanced simulation post-graduate degrees and fellowship programs have been developed. Many simulation educators “learn by doing” and using adjunctive tools and debriefing methods to help guide them throughout the process. Peer teaching can be helpful in providing debriefing of the debriefer if multiple facilitators are available for simulation. There is a growing body of literature describing the characteristics of effective debriefing models and the utility of different debriefing techniques in the context of medical simulation.

With the vast amount of published literature regarding debriefing, it may be challenging for simulation educators to gain an overarching understanding of various techniques and methods. This article briefly summarizes the most common debriefing methods and techniques. Additionally, it highlights the prevailing rules and essentials of effective debriefing.