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Gardner AK, Rodgers DL, Steinert Y, Davis R, Condron C, Peterson DT, Rohra A, Viggers S, Eppich WJ, Reedy G. Mapping the Terrain of Faculty Development for Simulation: A Scoping Review. Simul Healthc 2024; 19:S75-S89. [PMID: 38240621 DOI: 10.1097/sih.0000000000000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.
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Affiliation(s)
- Aimee K Gardner
- From the Baylor College of Medicine (A.K.G., R.D., A.R.), Houston, TX; Indiana University School of Medicine (D.L.R.), Indianapolis, IN; McGill University, Faculty of Medicine and Health Sciences (Y.S.), Montréal, Canada; Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, RCSI SIM Center for Simulation Education and Research (C.C., W.J.E.), Dublin, Ireland; The University of Alabama at Birmingham (D.T.P.), Birmingham, AL; Copenhagen Academy for Medical Education and Simulation (S.V.), Copenhagen, Denmark; and King's College London (G.R.), London, United Kingdom
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Duff JP, Morse KJ, Seelandt J, Gross IT, Lydston M, Sargeant J, Dieckmann P, Allen JA, Rudolph JW, Kolbe M. Debriefing Methods for Simulation in Healthcare: A Systematic Review. Simul Healthc 2024; 19:S112-S121. [PMID: 38240623 DOI: 10.1097/sih.0000000000000765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature. The PICO question for this review was defined as "In healthcare providers [P], does the use of one debriefing or feedback intervention [I], compared to a different debriefing or feedback intervention [C], improve educational and clinical outcomes [O] in simulation-based education?" We included 70 studies in our final review and found that our current debriefing strategies, frameworks, and techniques are not based on robust empirical evidence. Based on this, we highlight future research needs.
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Affiliation(s)
- Jonathan P Duff
- From the Department of Pediatrics (J.P.D.), University of Alberta. Edmonton, Canada; College of Nursing and Health Professions (K.J.M.), Drexel University, Philadelphia, PA; Simulation Centre (J.S., M.K.), University Hospital, Zurich, Switzerland; Department of Pediatrics, Section of Emergency Medicine (I.T.G.), Yale University School of Medicine, New Haven, CT; Treadwell Virtual Library (M.L.), Massachusetts General Hospital, Boston, MA; Faculty of Medicine (J.S.), Dalhousie University, Halifax, Canada; Copenhagen Academy for Medical Education and Simulation (CAMES) (P.D.), Herlev, Denmark; Department of Quality and Health Technology (P.D.), University of Stavanger, Stavanger, Norway; Department of Public Health (P.D.), University of Copenhagen, Denmark; Department of Family and Preventive Medicine (J.A.A.), University of Utah, Salt Lake City, UT; Center for Medical Simulation (J.W.R.), Boston, MA; and ETH Zurich (M.K.), Zurich, Switzerland
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Bradley CS, Johnson BK, Woda A, Hansen J, Loomis A, Dreifuerst KT. The Impact of Single-Dose Debriefing for Meaningful Learning Training on Debriefer Quality, Time, and Outcomes: Early Evidence to Inform Debriefing Training and Frequency. Nurs Educ Perspect 2023; 44:E33-E38. [PMID: 37493400 DOI: 10.1097/01.nep.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
AIM This study evaluated the impact of a single dose of training in Debriefing for Meaningful Learning (DML) on learner knowledge outcomes and time spent in debriefing. BACKGROUND Regulatory bodies recommend that faculty who debrief receive training and competence assessment to ensure positive student learning outcomes, yet there is little literature describing the training needed. There is also little understanding of the impact of a single training on the length of debriefing, debriefer skill, and learner outcomes. METHOD Following training, debriefers submitted a recorded debriefing for assessment by experts; their learners completed knowledge assessment tests at three time points. RESULTS Longer debriefing time led to higher DML Evaluation Scale scores. Learner knowledge scores improved and later decayed. CONCLUSION The results of this study contribute to the evidence about the importance of training to debrief well, the impact of training on the length of debriefing time, and subsequent learner outcomes.
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Affiliation(s)
- Cynthia Sherraden Bradley
- About the Authors Cynthia Sherraden Bradley, PhD, RN, CNE, CHSE, ANEF, is assistant professor and director of simulation, University of Minnesota School of Nursing, Minneapolis, Minnesota. Brandon Kyle Johnson, PhD, RN, CHSE, is associate professor and associate dean for simulation, Texas Tech University Health Sciences Center School of Nursing, Lubbock, Texas. Aimee Woda, PhD, RN, BC, is associate professor, Marquette University College of Nursing, Milwaukee, Wisconsin. Jamie Hansen, PhD, RN, CNE, is a clinical professor, Carroll University College of Health Sciences, Waukesha, Wisconsin. Ann Loomis, PhD, RN, CNEcl, is a clinical assistant professor, Purdue University School of Nursing, West Lafayette, Indiana. Kristina Thomas Dreifuerst, PhD, RN, CNE, ANEF, FAAN, is professor and director, PhD Program, Marquette University College of Nursing. This research was supported by a National League for Nursing Research Grant. For more information, contact Dr. Bradley at
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Kolbe M, Goldhahn J, Useini M, Grande B. "Asking for help is a strength"-how to promote undergraduate medical students' teamwork through simulation training and interprofessional faculty. Front Psychol 2023; 14:1214091. [PMID: 37701867 PMCID: PMC10494543 DOI: 10.3389/fpsyg.2023.1214091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/01/2023] [Indexed: 09/14/2023] Open
Abstract
The ability to team up and safely work in any kind of healthcare team is a critical asset and should be taught early on in medical education. Medical students should be given the chance to "walk the talk" of teamwork by training and reflecting in teams. Our goal was to design, implement and evaluate the feasibility of a simulation-based teamwork training (TeamSIM) for undergraduate medical students that puts generic teamwork skills centerstage. We designed TeamSIM to include 12 learning objectives. For this pre-post, mixed-methods feasibility study, third-year medical students, organized in teams of 11-12 students, participated and observed each other in eight simulations of different clinical situation with varying degrees of complexity (e.g., deteriorating patient in ward; trauma; resuscitation). Guided by an interprofessional clinical faculty with simulation-based instructor training, student teams reflected on their shared experience in structured team debriefings. Using published instruments, we measured (a) students' reactions to TeamSIM and their perceptions of psychological safety via self-report, (b) their ongoing reflections via experience sampling, and (c) their teamwork skills via behavior observation. Ninety four students participated. They reported positive reactions to TeamSIM (M = 5.23, SD = 0.5). Their mean initial reported level of psychological safety was M = 3.8 (SD = 0.4) which rose to M = 4.3 (SD = 0.5) toward the end of the course [T(21) = -2.8, 95% CI -0.78 to-0.12, p = 0.011 (two-tailed)]. We obtained n = 314 headline reflections from the students and n = 95 from the faculty. For the students, the most frequent theme assigned to their headlines involved the concepts taught in the course such as "10 s for 10 min." For the faculty, the most frequent theme assigned to their headlines were reflections on how their simulation session worked for the students. The faculty rated students' teamwork skills higher after the last compared to the first debriefing. Undergraduate medical students can learn crucial teamwork skills in simulations supported by an experienced faculty and with a high degree of psychological safety. Both students and faculty appreciate the learning possibilities of simulation. At the same time, this learning can be challenging, intense and overwhelming. It takes a team to teach teamwork.
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Affiliation(s)
- Michaela Kolbe
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Jörg Goldhahn
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Mirdita Useini
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Bastian Grande
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland
- Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland
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Kolbe M, Grande B, Lehmann-Willenbrock N, Seelandt JC. Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings. BMJ Qual Saf 2023; 32:160-172. [PMID: 35902231 DOI: 10.1136/bmjqs-2021-014393] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/21/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Debriefings help teams learn quickly and treat patients safely. However, many clinicians and educators report to struggle with leading debriefings. Little empirical knowledge on optimal debriefing processes is available. The aim of the study was to evaluate the potential of specific types of debriefer communication to trigger participants' reflection in debriefings. METHODS In this prospective observational, microanalytic interaction analysis study, we observed clinicians while they participated in healthcare team debriefings following three high-risk anaesthetic scenarios during simulation-based team training. Using the video-recorded debriefings and INTERACT coding software, we applied timed, event-based coding with DE-CODE, a coding scheme for assessing debriefing interactions. We used lag sequential analysis to explore the relationship between what debriefers and participants said. We hypothesised that combining advocacy (ie, stating an observation followed by an opinion) with an open-ended question would be associated with participants' verbalisation of a mental model as a particular form of reflection. RESULTS The 50 debriefings with overall 114 participants had a mean duration of 49.35 min (SD=8.89 min) and included 18 486 behavioural transitions. We detected significant behavioural linkages from debriefers' observation to debriefers' opinion (z=9.85, p<0.001), from opinion to debriefers' open-ended question (z=9.52, p<0.001) and from open-ended question to participants' mental model (z=7.41, p<0.001), supporting our hypothesis. Furthermore, participants shared mental models after debriefers paraphrased their statements and asked specific questions but not after debriefers appreciated their actions without asking any follow-up questions. Participants also triggered reflection among themselves, particularly by sharing personal anecdotes. CONCLUSION When debriefers pair their observations and opinions with open-ended questions, paraphrase participants' statements and ask specific questions, they help participants reflect during debriefings.
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Affiliation(s)
- Michaela Kolbe
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland .,ETH Zürich, Zurich, Switzerland
| | - Bastian Grande
- Simulation Centre, University Hospital Zurich, Zurich, Switzerland.,Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
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Madsgaard A, Røykenes K, Smith-Strøm H, Kvernenes M. The affective component of learning in simulation-based education - facilitators' strategies to establish psychological safety and accommodate nursing students' emotions. BMC Nurs 2022; 21:91. [PMID: 35443709 PMCID: PMC9019791 DOI: 10.1186/s12912-022-00869-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Active learning situations such as simulation-based education (SBE) are found to trigger a wide range of emotions among students. Facilitators have an important educational role in SBE which include being attentive and adaptive to students’cognitive and affective responses. Although the importance of emotions in SBE is recognized in facilitator guidelines, little is known about how facilitators accommodate student affect. Hence, this study explores facilitators’ strategies for addressing students’ emotions in SBE. Method Individual interviews with nine facilitators were performed and transcripts were subjected to qualitative analyses in accordance with interpretive description approach. Results Findings show that facilitators are attentive to and continuously assess students’ emotional responses in SBE. Both positive emotions, such as interest and surprise, and negative emotions such as anxiety are cultivated, yet adapted to the perceived needs of the individual student. Psychological safety was seen as a prerequisite for optimal learning, regardless of the students’ previous level of knowledge. Furthermore, significant learning was seen as something that might also arise from uncomfortable experiences, such as students realizing their own mistakes or uncertainty. Hence facilitators were found to balance levels of difficulty, emotional arousal and psychological safety during the various phases of SBE. Conclusion Facilitators recognize the emotional dimension of learning in SBE and have numerous strategies for accommodating students’ emotions. This study highlights the complexity of the facilitator’s role in adapting training to individual cognitive and emotional needs. These findings have implications for facilitator training which should include awareness of the role of emotions in learning and strategies for observing and accommodating training to meet emotional needs.
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Affiliation(s)
- Anine Madsgaard
- VID Specialized University, Ulriksdalen 10, 5009, Bergen, Norway.
| | - Kari Røykenes
- VID Specialized University, Ulriksdalen 10, 5009, Bergen, Norway
| | | | - Monika Kvernenes
- University of Bergen, VID Specialized University, Bergen, Norway
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Seelandt JC, Walker K, Kolbe M. "A debriefer must be neutral" and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing. Adv Simul (Lond) 2021; 6:7. [PMID: 33663598 PMCID: PMC7931165 DOI: 10.1186/s41077-021-00161-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The goal of this study was to identify taken-for-granted beliefs and assumptions about use, costs, and facilitation of post-event debriefing. These myths prevent the ubiquitous uptake of post-event debriefing in clinical units, and therefore the identification of process, teamwork, and latent safety threats that lead to medical error. By naming these false barriers and assumptions, the authors believe that clinical event debriefing can be implemented more broadly. METHODS We interviewed an international sample of 37 clinicians, educators, scholars, researchers, and healthcare administrators from hospitals, universities, and healthcare organizations in Western Europe and the USA, who had a broad range of debriefing experience. We adopted a systemic-constructivist approach that aimed at exploring in-depth assumptions about debriefing beyond obvious constraints such as time and logistics and focused on interpersonal relationships within organizations. Using circular questions, we intended to uncover new and tacit knowledge about barriers and facilitators of regular clinical debriefings. All interviews were transcribed and analyzed following a comprehensive process of inductive open coding. RESULTS In total, 1508.62 min of interviews (25 h, 9 min, and 2 s) were analyzed, and 1591 answers were categorized. Many implicit debriefing theories reflected current scientific evidence, particularly with respect to debriefing value and topics, the complexity and difficulty of facilitation, the importance of structuring the debriefing and engaging in reflective practice to advance debriefing skills. We also identified four debriefing myths which may prevent post-event debriefing from being implemented in clinical units. CONCLUSION The debriefing myths include (1) debriefing only when disaster strikes, (2) debriefing is a luxury, (3) senior clinicians should determine debriefing content, and (4) debriefers must be neutral and nonjudgmental. These myths offer valuable insights into why current debriefing practices are ad hoc and not embedded into daily unit practices. They may help ignite a renewed momentum into the implementation of post-event debriefing in clinical settings.
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Affiliation(s)
- Julia Carolin Seelandt
- Simulation Center, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Katie Walker
- New York City, Health + Hospitals Simulation Center, 1400 Pelham Parkway South, Building 4, 2nd Floor, Bronx, NY 10461 USA
| | - Michaela Kolbe
- Simulation Center, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
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Abstract
STATEMENT Formal training for educators who use simulation-based education (SBE) is required by standards of best practice, simulation guidelines, regulatory, and accrediting bodies. Training efforts to establish educator competency for SBE are being offered. However, a systematic review of this body of literature has yet to be conducted. The purpose of this integrative review was to appraise formal training efforts of educators who use SBE. The aims were to summarize the training topics, describe the structure of training programs, and explore evaluation methods of educators. The New World Kirkpatrick Model guided the review. A PRISMA search approach yielded 2007 citations of which 38 met inclusion criteria. Analysis supports a formalized training process that uses a combination of didactic material, time for repetitive practice, and ongoing feedback with longitudinal and scaffolded delivery approaches. An identified gap in the literature is threshold levels for determining competency of educators. Recommendations for planning simulation training programs are provided.
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Kündig P, Tschan F, Semmer NK, Morgenthaler C, Zimmermann J, Holzer E, Huber SA, Hunziker S, Marsch S. More than experience: a post-task reflection intervention among team members enhances performance in student teams confronted with a simulated resuscitation task-a prospective randomised trial. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:81-86. [PMID: 35516080 DOI: 10.1136/bmjstel-2018-000395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/04/2022]
Abstract
Background Teams that regularly step back from action and deliberately reflect on their performance and strategies show higher performance. Ad hoc emergency teams with changing team composition cannot develop such habits but may engage in short postaction reflection to discuss shortcomings of past performance and potential adaptations of their strategies for future similar tasks. This study aimed to test the effect of a short postaction self-led reflective team briefing on resuscitation performance in a simulator setting in terms of three performance parameters: hands-on time, coordination between chest compression and ventilation, and defibrillation. Methods We performed a randomised controlled trial including 56 ad hoc formed teams of three fourth-year medical students each. All groups performed a resuscitation task, followed by a self-guided reflective briefing, based on a general instruction (n=28 teams), or an unrelated discussion session (control condition; n=29), followed by a second resuscitation task in the same team composition. Results Adjusted for performance in the first task, teams in the reflection condition showed higher performance gain in the second resuscitation than teams in the control condition (6.21 percentage points (95% CI 1.31 to 11.10, p<0.001)) for basic hands-on performance; 15.0 percentage points (95% CI 2 to 28, p<0.001) for coordinative performance but non-significantly lower performance for defibrillation (-9%, 95% CI -27% to -9%, p=0.312). Conclusion Even very short self-led postaction reflective briefings enhance basic resuscitation performance in ad hoc groups but may not influence more complex aspects of the task. We recommend including short self-led team debriefings as part of simulator training.
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Affiliation(s)
- Patrizia Kündig
- Department of Anesthesiology, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Franziska Tschan
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | | | - Camille Morgenthaler
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Jasmin Zimmermann
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Eliane Holzer
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Simon Andreas Huber
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital of Basel, Basel, Switzerland
| | - Stephan Marsch
- Medical Intensive Care, University Hospital of Basel, Basel, Switzerland
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Dube M, Kessler D, Huang L, Petrosoniak A, Bajaj K. Considerations for psychological safety with system-focused debriefings. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 6:132-134. [DOI: 10.1136/bmjstel-2019-000579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 01/09/2020] [Indexed: 11/03/2022]
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Kolbe M, Eppich W, Rudolph J, Meguerdichian M, Catena H, Cripps A, Grant V, Cheng A. Managing psychological safety in debriefings: a dynamic balancing act. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2019; 6:164-171. [DOI: 10.1136/bmjstel-2019-000470] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/27/2019] [Accepted: 08/05/2019] [Indexed: 12/28/2022]
Abstract
Debriefings should promote reflection and help learners make sense of events. Threats to psychological safety can undermine reflective learning conversations and may inhibit transfer of key lessons from simulated cases to the general patient care context. Therefore, effective debriefings require high degrees of psychological safety—the perception that it is safe to take interpersonal risks and that one will not be embarrassed, rejected or otherwise punished for speaking their mind, not knowing or asking questions. The role of introductions, learning contracts and prebriefing in establishing psychological safety is well described in the literature. How to maintain psychological safety, while also being able to identify and restore psychological safety during debriefings, is less well understood. This review has several aims. First, we provide a detailed definition of psychological safety and justify its importance for debriefings. Second, we recommend specific strategies debriefers can use throughout the debriefing to build and maintain psychological safety. We base these recommendations on a literature review and on our own experiences as simulation educators. Third, we examine how debriefers might actively address perceived breaches to restore psychological safety. Re-establishing psychological safety after temporary threats or breaches can seem particularly daunting. To demystify this process, we invoke the metaphor of a ‘safe container’ for learning; a space where learners can feel secure enough to work at the edge of expertise without threat of humiliation. We conclude with a discussion of limitations and implications, particularly with respect to faculty development.
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Kolbe M, Boos M. Laborious but Elaborate: The Benefits of Really Studying Team Dynamics. Front Psychol 2019; 10:1478. [PMID: 31316435 PMCID: PMC6611000 DOI: 10.3389/fpsyg.2019.01478] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 06/11/2019] [Indexed: 11/13/2022] Open
Abstract
In this manuscript we discuss the consequences of methodological choices when studying team processes "in the wild." We chose teams in healthcare as the application because teamwork cannot only save lives but the processes constituting effective teamwork in healthcare are prototypical for teamwork as they range from decision-making (e.g., in multidisciplinary decision-making boards in cancer care) to leadership and coordination (e.g., in fast-paced, acute-care settings in trauma, surgery and anesthesia) to reflection and learning (e.g., in post-event clinical debriefings). We draw upon recently emphasized critique that much empirical team research has focused on describing team states rather than investigating how team processes dynamically unfurl over time and how these dynamics predict team outcomes. This focus on statics instead of dynamics limits the gain of applicable knowledge on team functioning in organizations. We first describe three examples from healthcare that reflect the importance, scope, and challenges of teamwork: multidisciplinary decision-making boards, fast-paced, acute care settings, and post-event clinical team debriefings. Second, we put the methodological approaches of how teamwork in these representative examples has mostly been studied centerstage (i.e., using mainly surveys, database reviews, and rating tools) and highlight how the resulting findings provide only limited insights into the actual team processes and the quality thereof, leaving little room for identifying and targeting success factors. Third, we discuss how methodical approaches that take dynamics into account (i.e., event- and time-based behavior observation and micro-level coding, social sensor-based measurement) would contribute to the science of teams by providing actionable knowledge about interaction processes of successful teamwork.
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Affiliation(s)
- Michaela Kolbe
- Simulation Center, University Hospital Zurich, Zurich, Switzerland
| | - Margarete Boos
- Institute for Psychology, University of Göttingen, Göttingen, Germany
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Kerry MJ, Ander DS. Mindfulness fostering of interprofessional simulation training for collaborative practice. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2018; 5:144-150. [DOI: 10.1136/bmjstel-2018-000320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 11/04/2022]
Abstract
Introduction The setting demands imposed by performing in new, interdisciplinary cultures is common for modern healthcare workers. Both health science students and evidence-based workers are required to operate in professional cultures that differ from their own. As health organisations have placed increasing value on mindfulness for improving performance outcomes, so too have educational administrators embraced common, mindful competencies for improving training for improved patient outcomes. The training of future clinicians for diversified care. teams and patient populations has become known as interprofessional education (IPE). Although the goals for IPE suggest that individual differences in trait mindfulness may serve an important determinant for training effectiveness, it has gone unstudied in extant simulation training research.MethodsTo fill this gap, in this paper, we examine trait mindfulness’ predictive power for training outcomes across two IPE cohort samples using two, prospective observational designs.Results Study 1’s Findings supported trait mindfulness’ prediction of perceived teamwork behaviours in training simulations between medical and nursing students (n=136). In study 2’s expanded sample to five health professions (n=232), findings extended trait mindfulness’ prediction of team efficacy and skill transfer, assessed 1 month after training.Conclusion A final, follow-up assessment 16 months later extended mindfulness’ predictive validity to knowledge retention and teamwork attitudes. We discuss the theoretical and practical implication of our findings for advancing mindfulness research and IPE effectiveness assessment.
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Aitken JA, Torres EM, Kaplan SA, DiazGranados D, Su L, Parker SH. Influence of Simulation-based Training on Reflective Practice. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2016; 7:638-640. [PMID: 34484807 PMCID: PMC8411838 DOI: 10.1136/bmjstel-2021-000870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Simulation-based training (SBT) is often evaluated based on the transfer of specific knowledge and skills. In contrast, the degree to which reflective practice is inculcated by SBT is rarely considered. Because reflection is a pillar of adult learning theories, we sought to examine the degree to which participation in SBT was associated with increased reflective practice. Method Eighty one healthcare professionals completed a survey which included the number of SBTs they participated in during the past two years, content- and administrative-related features of those SBTs, and a key aspect of reflective practice (i.e., self-appraisal). Results The number of SBTs healthcare professionals participated in during the past two years was positively associated with reflective self-appraisal. This relationship was not moderated by the inclusion of reflection components in SBTs nor by the voluntary/mandatory nature of participation in SBTs. Furthermore, the facilitator was ranked as the most important feature of the overall learning experience in SBTs. Also, no significant differences were found between the number of technical skills-based and non-technical skills-based SBTs. Conclusion These findings demonstrate the importance (of evaluating) SBTs for facilitating reflective learning mindsets that healthcare practitioners can apply beyond the specific skills trained by SBTs.
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Affiliation(s)
- John A Aitken
- Psychology Department, George Mason University, Fairfax, Virginia, USA
| | - Elisa M Torres
- Psychology Department, George Mason University, Fairfax, Virginia, USA
| | - Seth A Kaplan
- Psychology Department, George Mason University, Fairfax, Virginia, USA
| | - Deborah DiazGranados
- School of Medicine and Evaluation and Team Science at the Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA
| | - Lillian Su
- Division of Critical Care Medicine, Children's National Health System, Washington, District of Columbia, USA
| | - Sarah Henrickson Parker
- Human Factors Research, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, Virginia, USA
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