Abstract
BackgroundDebriefing is a critical component to promote effective learning during simulation-based training. Traditionally, debriefing is provided only after the end of a scenario. A possible alternative is to debrief specific portions during an ongoing simulation session (stop-and-go debriefing). While this alternative has theoretical advantages, it is not commonly used due to concerns that interruptions disturb the fidelity and adversely affect learning. However, both approaches have not been rigorously compared, and effects on skill acquisition and learning experience are unknown.MethodsWe randomly assigned 50 medical students participating in a simulation-based cardiopulmonary resuscitation training to either a post-scenario debriefing or stop-and-go debriefing. After four weeks, participants performed a repeat scenario, and their performance was assessed using a generic performance score (primary outcome). A difference of 3 or more points was considered meaningful. A 5-item questionnaire was used to assess the subjective learning experience and the perceived stress level (secondary outcomes).ResultsThere was no significant difference between the groups for the performance score (mean difference: -0.35, 95%CI: -2.46 to 1.77, P = 0.748, n = 48). The confidence limits excluding the specified relevant 3-point difference suggest equivalence of both techniques with respect to the primary outcome. No significant differences were observed for secondary outcomes.ConclusionsStop-and-go debriefing does not adversely affect skill acquisition compared to the classic post-scenario debriefing strategy. This finding is reassuring when interruptions are deemed necessary and gives simulation instructors the latitude to tailor the timing of the debriefing individually, rather than adhering to the unsupported dogma that scenarios should not be interrupted.Trial registrationAs this study is not a clinical trial, it was not registered in a clinical trials register.
Highlights
Debriefing is a critical component to promote effective learning during simulation-based training
As no validated instrument exists to assess performance during basic life support (BLS), we developed a scoring protocol to summarize the participants’ performance for the purpose of this study, based on the experience with previous studies of our research group in which a similar scoring protocol was developed [10, 11]
No statistically significant difference was found between the groups for the performance score in the main analysis
Summary
Debriefing is a critical component to promote effective learning during simulation-based training. A possible alternative is to debrief specific portions during an ongoing simulation session (stop-and-go debriefing). While this alternative has theoretical advantages, it is not commonly used due to concerns that interruptions disturb the fidelity and adversely affect learning. Both approaches have not been rigorously compared, and effects on skill acquisition and learning experience are unknown. A possible alternative could be to time-out the scenario to debrief specific portions or events during an ongoing simulation session. The disadvantage of interrupting a scenario is an inherent reduction in the level of fidelity, and it might affect the participant’s engagement in the scenario [4]
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