Sim for Life: Foundations—A Simulation Educator Training Course to Improve Debriefing Quality in a Low Resource Setting

Abstract

Introduction Despite the importance of debriefing, little is known about the effectiveness of training programs designed to teach debriefing skills. In this study, we evaluated the effectiveness of a faculty development program for new simulation educators at Mbarara University of Science and Technology in Uganda, Africa. Methods Healthcare professionals were recruited to attend a 2-day simulation educator faculty development course (Sim for Life: Foundations), covering principles of scenario design, scenario execution, prebriefing, and debriefing. Debriefing strategies were contextualized to local culture and focused on debriefing structure, conversational strategies, and learner centeredness. A debriefing worksheet was used to support debriefing practice. Trained simulation educators taught simulation sessions for 12 months. Debriefings were videotaped before and after initial training and before and after 1-day refresher training at 12 months. The quality of debriefing was measured at each time point using the Objective Structured Assessment of Debriefing (OSAD) tool by trained, calibrated, and blinded raters. Results A total of 13 participants were recruited to the study. The mean (95% confidence interval) OSAD scores pretraining, posttraining, and at 12 months before and after refresher were 18.2 (14.3–22.1), 26.7 (22.8–30.6), 25.5 (21.2–29.9), and 27.0 (22.4–31.6), respectively. There was a significant improvement from pretraining to posttraining (P < 0.001), with no significant decay from posttraining to 12 months (P = 0.54). There was no significant difference in OSAD scores pre– versus post–refresher training at 12 months (P = 0.49). Conclusions The Sim for Life Foundations program significantly improves debriefing skills with retention of debriefing skills at 12 months.

Nursing Students Reported More Positive Emotions About Training During Coronavirus Disease 2019 (COVID-19) After Using a Virtual Simulation Paired With an In-person Simulation

“…The ongoing pandemic limited the success of our recruitment, but this was a single condition study. As such, 18 participants is comparable or greater than similar studies ( Bench et al, 2019 ; Chang et al, 2019 ; Kattan et al, 2021 ; LeFlore et al, 2007 ; Michelet et al, 2019 ; Mormando et al, 2021 ; Robinson et al, 2020 ) and aligns with or exceeds minimal sample size recommendations ( Donner & Eliasziw, 1987 ; Jiin-Huarng & Wei-Ming, 2008). Based on a post-hoc power analyses comparing the population means of medical emotions in a previous study ( Duffy et al, 2020 ) to our study means, we had a sufficient sample size to achieve 80% power and 5% α values for all four medical emotion variables measured except for positive deactivating emotions.…”

Cultural Considerations in Debriefing

“…It is important that we take a focused look at whether the debriefing techniques that we learned are applicable to the environment in which we facilitate learning. [31][32][33] Debriefers should be encouraged to assess their learners beyond the usual age, sex, years of experience, and clinical profession by also considering their individual and group cultural compositions. Debriefers must also take care to avoid assumptions and generalizations that may not be true.…”

“…In our search for peer-reviewed articles in all languages with a focus on healthcare simulation debriefing and global cultural considerations during debriefing (not limited to particular study methods, profession, learner level, or date of publication), we found 3 articles (Table 2). [31][32][33] The purpose of these 3 articles differed greatly with a wide variation between methods, findings, and information reported, making it difficult to discuss recommendations for debriefers solely based on that data.…”

Improving Newborn Resuscitation by Making Every Birth a Learning Event

“…These barriers can be addressed through targeted training in debriefing, support for less-experienced facilitators, including a video review to objectively establish the sequence of events and emphasize learning points, and interventions that focus on developing a culture of improvement [ 104 , 105 , 106 ]. For example, Sim for Life Foundations is a two-day course in debriefing developed for new faculty in simulation education in Uganda [ 110 ]. A pilot study of this curriculum demonstrated that faculty who completed the training showed a significant improvement in their debriefing skills that persisted at a 12-month reassessment.…”