Oral Themed Presentation
Context: : Debriefing is a critical component in experiential learning contexts and simulation-based training (SBT). Despite debriefing’s central importance to learning in SBT, little is known about how to optimally deliver courses to teach debriefing skills. Courses in continuing medical education often use simulation-based methods but provide minimal training in debriefing to instructors. The Society for Pediatric Sedation (SPS) has conducted pediatric procedural sedation training courses for over 10 years where faculty serve as facilitators on pediatric procedural sedation using simulation-based cases. However, their ability to provide effective debriefing is seldom formally taught or assessed. Thus, we implemented and evaluated a novel debriefing training workshop conducted prior to the simulation-based sedation training course.
Description: : The theoretical frame of this workshop was based on using debriefing in fostering learning based on Kolb’s theory of experiential learning. The workshop was designed by 4 content experts in debriefing and pediatric procedural sedation who served as lead instructors and incorporated 3 core components. 1) A 30-minutes didactic that focused on the key elements of effective debriefing where facilitators were handed the (Promoting Excellence and Reflective Learning in Simulation) PEARLS as an adjunctive tool. 2) A simulated debriefing station performed by lead instructors where they conduced “simulated” effective and ineffective debriefing using the PEARLS tool following a brief simulated video. This allowed facilitators to engage and incorporate the theoretical principles of effective debriefing. 3) Practice sessions, where all facilitators were assigned to small groups, each with a lead instructor. Facilitators conducted a full-length debriefing, transitioned between all debriefing phases and engaged in debriefing of other facilitators, all followed by constructive feedback. This instructional feature integrated repetitive practice to apply what was learned in an experiential manner.
Observation/Evaluation: : Facilitators’ demographics are shown in table 1. Following the workshop, facilitators rated their pre-course confidence in debriefing as 2.47 on a 5-point Likert scale, and after the course as 4.20 (p-value<0.01). The following day, all facilitators debriefed simulation sessions in the pediatric sedation course. All debriefing sessions were analyzed by the lead instructors using the Objective Structured Assessment of Debriefing (OSAD), a validated debriefing assessment tool. The median OSAD score was 31 with inter-rater reliability between two raters ranging from 0.6850 to 0.9921. Pediatric sedation course student learner evaluations (n=24) revealed a high-degree of satisfaction with the quality of the education: found the debriefing environment to be safe and nonthreatening, a friendly non-judgmental atmosphere and promoted engagement in self-reflective discussions (4.9 out 5 point Likert scale).
Discussion: : Debriefing training of faculty in the context of simulation-based continuing medical education courses is a feasible model to promote faculty debriefing skills. This model could be incorporated into already established mechanisms for continuing medical education (CME) to provide the most convenient and least disruptive manner as part of “train the trainer” debriefing courses for any sub-specialty debriefing.