Communication content during debriefing in simulation-based medical education: An analytic framework and mixed-methods analysis

2020 ◽

pp. bmjstel-2020-000645

Author(s):

Leo Nunnink ◽

Andrea Thompson ◽

Nemat Alsaba ◽

Victoria Brazil

Keyword(s):

Medical Education ◽

Mixed Methods ◽

Medical Students ◽

Focus Group ◽

Exploratory Study ◽

Free Text ◽

Perceived Benefits ◽

Simulated Environment ◽

Simulation Based ◽

Peer Teachers

IntroductionPeer-assisted learning (PAL) is well described in medical education but there has been little research on its application in simulation-based education (SBE). This exploratory study aimed to determine the perceptions of senior medical students at two universities to teaching and learning in SBE using PAL (PAL-SBE).MethodsNinety-seven medical students at two universities working in small groups with facilitator oversight wrote, ran and debriefed a simulation scenario for their peers.This was a mixed-methods study. Participants completed a written free-text and Likert survey instrument, and participated in a facilitated focus group immediately after the scenario. Thematic analysis was performed on the free-text and focus group transcripts.ResultsStudent-led scenarios ran without major technical issues. Instructor presence was required throughout scenario delivery and debrief, making the exercise resource intensive. Participant responses were more positive regarding learning as peer teachers in simulation than they were regarding participation as a peer learner. Five themes were identified: learning in the simulated environment; teaching in the simulated environment; teaching peers and taking on an educator role; learning from peers; and time and effort expended. Perceived benefits included learning in depth through scenario writing, improved knowledge retention, understanding the patient’s perspective and learning to give feedback through debriefing.ConclusionPAL in SBE is feasible and was perceived positively by students. Perceived benefits appear to be greater for the peer teachers than for peer learners.

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52. Simulation based training improves resident competence in the performance of critical resuscitation procedures

Clinical & Investigative Medicine ◽

10.25011/cim.v30i4.2813 ◽

2007 ◽

Vol 30 (4) ◽

pp. 56

Author(s):

I. Rigby ◽

I. Walker ◽

T. Donnon ◽

D. Howes ◽

J. Lord

Keyword(s):

Internal Medicine ◽

Emergency Medicine ◽

Medical Education ◽

Family Medicine ◽

Training Program ◽

Correlation Coefficient ◽

Training Programs ◽

Self Assessment ◽

Procedural Skills ◽

Simulation Based

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.

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