Relaxation before Debriefing during High-fidelity Simulation Improves Memory Retention of Residents at Three Months

Abstract

Background High-fidelity simulation is known to improve participant learning and behavioral performance. Simulation scenarios generate stress that affects memory retention and may impact future performance. The authors hypothesized that more participants would recall three or more critical key messages at three months when a relaxation break was performed before debriefing of critical event scenarios. Methods Each resident actively participated in one scenario and observed another. Residents were randomized in two parallel-arms. The intervention was a 5-min standardized relaxation break immediately before debriefing; controls had no break before debriefing. Five scenario-specific messages were read aloud by instructors during debriefings. Residents were asked by telephone three months later to recall the five messages from their two scenarios, and were scored for each scenario by blinded investigators. The primary endpoint was the number of residents participating actively who recalled three or more messages. Secondary endpoints included: number of residents observing who recalled three or more messages, anxiety level, and debriefing quality. Results In total, 149 residents were randomized and included. There were 52 of 73 (71%) residents participating actively who recalled three or more messages at three months in the intervention group versus 35 of 76 (46%) among controls (difference: 25% [95% CI, 10 to 40%], P = 0.004). No significant difference was found between groups for observers, anxiety or debriefing quality. Conclusions There was an additional 25% of active participants who recalled the critical messages at three months when a relaxation break was performed before debriefing of scenarios. Benefits of relaxation to enhance learning should be considered for medical education.

An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education

“…However, other studies reveal that simulated settings can elicit a high degree of immersion, and also stress [89,90].…”

Personality traits affect anticipatory stress vulnerability and coping effectiveness in occupational critical care situations

“…Recent advances made it possible to overcome the limitations of standard laboratory tasks by implementing virtual reality or high-fidelity simulations (also called full scale simulations). Simulation environments enable situations still closer to real-life along with experimental control, hence allowing investigation of the direct effects of stress on professional performance 17 – 22 . Simulation studies usually focus on urgent and crucial professional situations, such as the management of critical care for anaesthetists 20 – 22 .…”

“…Simulation environments enable situations still closer to real-life along with experimental control, hence allowing investigation of the direct effects of stress on professional performance 17 – 22 . Simulation studies usually focus on urgent and crucial professional situations, such as the management of critical care for anaesthetists 20 – 22 . These simulations remain indispensable for training anesthesiology residents to practice in one of the most stressful medical professions 23 .…”

Impact of a Digital Cognitive Aid on the Performance of Military Healthcare Teams During Critical Care Management in a Warfront Injury Situation

“…Our study compared the difference in performance between the use of a digital CA and memory using the same protocol, which is the reference of care within the French Army, in simulated high-stakes crisis situations that can hamper decision making [28][29][30] and access to known information. 28 We found that the use of the digital CA improved performance on a set of preplanned observations and tasks, without testing the leader's problem-solving abilities, in scenarios designed to test the ability to perform immediate, short-term, standard lifesaving actions, rather than to establish a strategic care plan for patient management.…”