The UW Health Clinical Simulation Program (CSP) has three on-staff simulation educators with master’s degrees in medical and healthcare simulation education. With this expertise, they have created online and in-person education opportunities on best practices in simulation education. One of their in-person courses focuses on the best practices in debriefing and provides experiential practice in debriefing challenging situations. This opportunity was deemed imperative for our facilitators to experience before facilitating a debrief during this education. Information on what was taught and practiced during the course is below. We recommend that any facilitator who will be participating as an educator in your microaggressions simulations should attend a debriefing course that is delivered by a formally trained simulation educator. The course hosted by the CSP is molded to the type of education being run as well as the level of proficiency of the facilitator.
Objectives of the course included:
- Define debriefing in healthcare simulation terminology and best practices related to the PEARLS framework.
- Effectively create a psychologically safe environment for debriefing.
- Understand the techniques in mitigating difficult debriefing situations.
Prework for the in-person debriefing course consisted of a 1-hour online module with a background on adult learning theory and best practices in debriefing. The in-person portion of the course is 5 hours in length. The agenda is as follows:
- Introductions/Ice Breaker
- Debriefing Review
- PEARLS Framework
- Debriefing Experiential Activity 1
- Difficult Debriefing Overview
- Debriefing Experiential Activity 2
- Debriefing Experiential Activity 3
- Wrap Up/Questions
In this specific version of the debriefing course, CSP educators tailored the information in the debriefing review and difficult debriefing overview to discuss aspects of scenarios they might encounter during microaggression simulations. The PEARLS (Promoting Excellence and Reflective Learning in Simulation) method of debriefing (Eppich & Cheng, 2015) is a structured, learner-centered approach that is effective in promoting learning and improving performance in simulation-based education. In addition to being effective, PEARLS is also a practical and adaptable debriefing method that can be used in a variety of simulation education settings.
As seen in the agenda, participants in the course have three experiential debriefing sessions. CSP staff created a staged simulation in which they were they healthcare providers. After watching the video, CSP staff act as the learners and the participants act as the facilitators and debrief the simulation. Each experiential debriefing practice includes a different debriefing situation incorporating some difficult learner types. Following each debriefing experiential activity, participants “debrief the debrief” to discuss what went well and what they would change if they were to try the scenario again. This secondary debrief also allows time to dive into what aspects of the debrief could be encountered in the microaggressions simulations and how to overcome each.
Participants in the debriefing course found it tremendously helpful before they encountered learners during the microaggressions simulations. Although helpful, we found that “debriefs of the debrief” still needed to occur once the actual learners were going through microaggressions scenarios. This helped facilitators and standardized patients discuss learner reactions and the most appropriate way to respond. The need for further practice and discussion emphasized the fact that debriefing curriculum taught by formally trained simulationists is a must for this education.
References:
Eppich, C., & Cheng, A. (2015). Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10(1), 27-34.