Faculty Development for Medical Educators

Prebriefing is learner preparation.

• Provide goals/objectives
• Pre-learning
• Schedule/Basic orientation to sim environment/clear logistics
• Provide scheduled simulation times (week prior)

Briefing Introduction

• Briefing happens on the day of the activity/just prior to simulation
• During briefing instructor and students review goals/objectives.
• They also review logistics/room orientation.  This includes a review of the timeline of the simulation.
• Instructor answers learners' questions before starting.
• The goal is to set up a safe and supportive learning environment - "Psychological Safety"

Psychological Safety

We need to set up a supportive and safe learning environment

• We want learners to know that we know they are smart, caring, committed to your patients.
• We want them to come to learn and plan on doing your best everyday.
• Let them know that sometimes our best intentions are not realized because of other reasons (fatigue, stress, etc)
• In sim we seek to learn more about why things are done/not done in order to grow.
  • “No place for blame or shame”
• Confidentiality - “What happens in sim, stays in sim”
  • Will sign a consent/ Case details/performance are confidential as well
• Trigger Warning – leave a learner an “out” if needed

Fiction Contract

Learners need to suspend their reality to get the most out of the simulation experience.  

You should tell them:

• Simulation is not real world.
• We do our best to create the most authentic experience for you.
• If you can suspend reality and agree to the “fiction contract” you will get the most out of the session.
• While you may act differently in the real world, there are still many things we can learn together.  

Debriefing Introduction

• Most important feature of simulation-based education
• The essence of the simulation experience and essential for the learning process
• Allows for reflection for participants to consider their decisions and actions, integrate their experience into established theories or evidence-based protocols for future use
• “Simulation is just a good excuse for debriefing”
• Can be verbal, written, presentation, discussion, video review, individual or team based, SP feedback

In debriefing you want to reflect on the desired learner performance and the actual learner performance.  You want to consider what went well and what didn't go well.

You want to backup to your learning objectives, what happened in the simulation and link those to the learning outcomes.

Debriefing Models

• Debriefing with Good Judgement
• Rapid Cycle Debriefing
• Plus/Delta Approach
• Advocacy Inquiry

Debriefing Phases

• Reaction/Description
  • Time for learners to diffuse and decompress, "blow off steam"
  • Open-ended questions about how learners feel?
  • Review the facts of the event
• Understanding/Analysis
  • Preview topics/learning objectives
  • Explore, discuss, inquire
  • What happened? Why did it happen?
• Application/Summary
  • "Take-home messages."
  • Apply learning experience to a future encounter
  • Allow for learners' questions

Program Evaluation

• Why did a learner not do what we were expecting. 
• Review participant feedback/evaluations and performance.
• Meeting of content experts/sim staff and others.
• Based on evaluation you may have to revise sim or case materials.
• Lastly determine if Continuous Quality Improvement (CQI) needs to happen.