Brick in the Wall? Linking Quality of Debriefing to Participant Learning in Team Training of Interprofessional Students

Overview

Journal BMJ Simul Technol Enhanc Learn

Date 2022 May 6

PMID 35515739

Authors

John T Paige

Deborah D Garbee

Qingzhao Yu

John Zahmjahn

Raquel Baroni de Carvalho

Lin Zhu

Vadym Rusnak

Vladimir J Kiselov

Affiliations

Soon will be listed here.

Abstract

Background: The evidence for the conventional wisdom that debriefing quality determines the effectiveness of learning in simulation-based training is lacking. We investigated whether the quality of debriefing in using simulation-based training in team training correlated with the degree of learning of participants.

Methods: Forty-two teams of medical and undergraduate nursing students participated in simulation-based training sessions using a two-scenario format with after-action debriefing. Observers rated team performance with an 11-item Teamwork Assessment Scales (TAS) instrument (three subscales, team-based behaviours (5-items), shared mental model (3-items), adaptive communication and response (3-items)). Two independent, blinded raters evaluated video-recorded facilitator team prebriefs and debriefs using the Objective Structured Assessment of Debriefing (OSAD) 8-item tool. Descriptive statistics were calculated, t-test comparisons made and multiple linear regression and univariate analysis used to compare OSAD item scores and changes in TAS scores.

Results: Statistically significant improvements in all three TAS subscales occurred from scenario 1 to 2. Seven faculty teams taught learners with all scores ≥3.0 (except two) for prebriefs and all scores 3.5 (except one) for debriefs (OSAD rating 1=done poorly to 5=done well). Linear regression analysis revealed a single statistically significant correlation between debrief engagement and adaptive communication and response score without significance on univariate analysis.

Conclusions: Quality of debriefing does not seem to increase the degree of learning in interprofessional education using simulation-based training of prelicensure student teams. Such a finding may be due to the relatively high quality of the prebrief and debrief of the faculty teams involved in the training.

References

Lacerenza C, Marlow S, Tannenbaum S, Salas E . Team development interventions: Evidence-based approaches for improving teamwork. Am Psychol. 2018; 73(4):517-531. DOI: 10.1037/amp0000295. View

McGaghie W, Issenberg S, Petrusa E, Scalese R . A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010; 44(1):50-63. DOI: 10.1111/j.1365-2923.2009.03547.x. View

Salas E, Klein C, King H, Salisbury M, Augenstein J, Birnbach D . Debriefing medical teams: 12 evidence-based best practices and tips. Jt Comm J Qual Patient Saf. 2008; 34(9):518-27. DOI: 10.1016/s1553-7250(08)34066-5. View

Kim Y, Yoo J . The utilization of debriefing for simulation in healthcare: A literature review. Nurse Educ Pract. 2020; 43:102698. DOI: 10.1016/j.nepr.2020.102698. View

Rudolph J, Simon R, Dufresne R, Raemer D . There's no such thing as "nonjudgmental" debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2008; 1(1):49-55. DOI: 10.1097/01266021-200600110-00006. View

Zamjahn J, Baroni de Carvalho R, Bronson M, Garbee D, Paige J . eAssessment: development of an electronic version of the Objective Structured Assessment of Debriefing tool to streamline evaluation of video recorded debriefings. J Am Med Inform Assoc. 2018; 25(10):1284-1291. PMC: 7646921. DOI: 10.1093/jamia/ocy113. View

McLaughlin C, Barry W, Barin E, Kysh L, Auerbach M, Upperman J . Multidisciplinary Simulation-Based Team Training for Trauma Resuscitation: A Scoping Review. J Surg Educ. 2019; 76(6):1669-1680. DOI: 10.1016/j.jsurg.2019.05.002. View

Kyrkjebo J, Brattebo G, Smith-Strom H . Improving patient safety by using interprofessional simulation training in health professional education. J Interprof Care. 2006; 20(5):507-16. DOI: 10.1080/13561820600918200. View

Weller J, Boyd M, Cumin D . Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J. 2014; 90(1061):149-54. DOI: 10.1136/postgradmedj-2012-131168. View

10.

Paige J, Garbee D, Brown K, Rojas J . Using Simulation in Interprofessional Education. Surg Clin North Am. 2015; 95(4):751-66. DOI: 10.1016/j.suc.2015.04.004. View

11.

Mannix R, Nagler J . Tribalism in Medicine-Us vs Them. JAMA Pediatr. 2017; 171(9):831. DOI: 10.1001/jamapediatrics.2017.1280. View

12.

Baker V, Cuzzola R, Knox C, Liotta C, Cornfield C, Tarkowski R . Teamwork education improves trauma team performance in undergraduate health professional students. J Educ Eval Health Prof. 2015; 12:36. PMC: 4536358. DOI: 10.3352/jeehp.2015.12.36. View

13.

Wu M, Tang J, Etherington C, Walker M, Boet S . Interventions for improving teamwork in intrapartem care: a systematic review of randomised controlled trials. BMJ Qual Saf. 2019; 29(1):77-85. DOI: 10.1136/bmjqs-2019-009689. View

14.

Coppens I, Verhaeghe S, Van Hecke A, Beeckman D . The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial. J Clin Nurs. 2017; 27(1-2):77-85. DOI: 10.1111/jocn.13846. View

15.

Alzahrani N, Jones R, Rizwan A, Abdel-Latif M . Safety attitudes in hospital emergency departments: a systematic review. Int J Health Care Qual Assur. 2019; 32(7):1042-1054. PMC: 7068731. DOI: 10.1108/IJHCQA-07-2018-0164. View

16.

Paige J, Zamjahn J, Carvalho R, Yang S, Yu Q, Garbee D . Quality with quantity? Evaluating interprofessional faculty prebriefs and debriefs for simulation training using video. Surgery. 2019; 165(6):1069-1074. DOI: 10.1016/j.surg.2019.01.014. View

17.

Ryoo E, Ha E . The Importance of Debriefing in Simulation-Based Learning: Comparison Between Debriefing and No Debriefing. Comput Inform Nurs. 2015; 33(12):538-45. DOI: 10.1097/CIN.0000000000000194. View

18.

Braithwaite J, Clay-Williams R, Vecellio E, Marks D, Hooper T, Westbrook M . The basis of clinical tribalism, hierarchy and stereotyping: a laboratory-controlled teamwork experiment. BMJ Open. 2016; 6(7):e012467. PMC: 4985874. DOI: 10.1136/bmjopen-2016-012467. View

19.

Motola I, Devine L, Chung H, Sullivan J, Issenberg S . Simulation in healthcare education: a best evidence practical guide. AMEE Guide No. 82. Med Teach. 2013; 35(10):e1511-30. DOI: 10.3109/0142159X.2013.818632. View

20.

Marlow S, Hughes A, Sonesh S, Gregory M, Lacerenza C, Benishek L . A Systematic Review of Team Training in Health Care: Ten Questions. Jt Comm J Qual Patient Saf. 2017; 43(4):197-204. DOI: 10.1016/j.jcjq.2016.12.004. View