Oral Debriefing Research Articles

Three-Phase Video-Assisted Multidisciplinary Team Debriefing in High-Fidelity Blast Simulation through the Advocacy and Inquiry Method.

Video-assisted debriefing (VAD) combined with the advocacy and inquiry (A&I) technique is a tool that allows video playback of selected segments of a simulation, thereby helping the debriefers structure the session. However, no consensus exists on how to optimally perform a team debriefing. The authors demonstrate and describe the methodology of A&I debriefing in an instructional simulated blast scenario and assess the impact of VAD on residents' technical and nontechnical skills. After institutional review board approval, the authors performed a study with 50 residents who were randomly assigned to 2 groups. Group 1 (control, or no VAD; n = 25) consisted of residents who received oral debriefing by 1 independent faculty member without the recorded video of the simulation. Group 2 (intervention, or VAD; n = 25) consisted of residents who received VAD from the second independent faculty member. These residents repeated the same simulation scenario 1 week after their debrief. Every resident was assessed on the primary and secondary survey, as well as the nontechnical skills, based on the integrated skills score. The VAD group presented significantly higher values for the integrated skills score ( P < 0.001) compared with the no-VAD group. This demonstration of 3-phase VAD emphasizes important aspects of coherent simulation-based training: psychologic safety, A&I, reflection, cognitive frames, prebrief, main debrief, summary, and translation of new discoveries to real-life patient care. The unique audiovisual aspect of the VAD enhanced residents' performance in simulation.

ANALISIS FAKTOR KEPESERTAAN PROGRAM JAMINAN KESEHATAN NASIONAL DI KABUPATEN AGAM

The Social Security Administering Body (BPJS) is a legal entity established as the administering body for the health insurance program. In this case, social security has been designed as a form of social protection, in order to provide guarantees to all people so that they can fulfill their basic needs for a more decent life. Based on the data found, it stated that as many as 453,185 (86.35%) of the people of the Agam district had been recorded as member BPJS with the entire Agam Regency community totaling 524,829. However, this coverage is still categorized as low because it has not yet reached Universal Health Coverage (UHC) coverage at number 95% and for the district government of Agam itself is targeting the membership of the national health insurance in Agam district to reach 100 percent. This research technique uses qualitative research methods and data collection through interviews, where the interview process was carried out by an oral debriefing process that took place in one direction. The interview process is carried out by asking questions to the informants regarding the title of the research and later the informants will give their answers. Got the results in this study state that there are several factors for community participation in participating in the National Health Insurance program, including: Interest, Obedience, Social Effect, Warranty, and Experience.

Effectiveness of Video-assisted Debriefing Versus Standard Oral Debriefing Following Screen-based Simulation (CyberPatient TM) Training

Background: A common recommendation to develop skillful practice is to playback videos during debriefing; however, no study has addressed the advantages of such a technique. Objectives: The present study aimed to compare the pedagogical effectiveness of video-assisted debriefing and oral debriefing in simulation-based training. By comparing video-assisted debriefing and traditional oral debriefing, it was hypothesized that video-assisted debriefing would improve medical students' decision-making skills and professional attitudes. Methods: This quasi-experimental study used a pretest-posttest design. The study encompassed 76 medical students in the fourth year of their seven-year training program. The participants were selected using a census and were then randomly divided into intervention (video-assisted debriefing, n = 36) and control (oral debriefing, n = 40) groups. The required data were collected using a demographic information questionnaire, the Penn State College of Medicine Professionalism Questionnaire, and Lauri and Salantera’s (2002) Clinical Decision-making Questionnaire. Descriptive statistics such as mean and standard deviation were used to describe the participants’ characteristics. Paired t-test and independent t-test were run to compare the medical students’ clinical decision-making and professional attitude scores before and after the intervention within and between the groups. Results: There was no significant difference in the medical students’ clinical decision-making skills between the two groups before the intervention (P = 0.09); however, significant differences were observed in both groups after the intervention (P &lt; 0.001). Moreover, there was no significant difference in the professional attitude of medical students between the two groups before the intervention (P = 0.03); however, there were significant differences in both groups after the intervention (P &lt; 0.001). Conclusions: The findings revealed that simulation-based training with video-assisted debriefing was more effective in developing the undergraduate medical students' decision-making skills and promoting their professional attitudes.

Instructor-led oral debriefing technique in clinical nursing simulation: integrative review.

To analyze available scientific evidence in literature pertaining to the elements that make the instructor-led oral debriefing technique in clinical nursing simulation feasible. An Integrative literature review along the following information sources: PubMed®, Scopus, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) [Latin American and Caribbean Health Sciences Literature], Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resources Information Centre (ERIC). 284 studies were identified, and 5 composed the sample. Four elements constitute oral debriefing: characteristics of the instructor; discussion format, debriefing structure; and time frame. The main benefit was to develop cognitive and psychomotor skills; and the challenge was to establish training for instructors. The studies showed high methodological quality. The scientific deepening as to the elements, benefits, and challenges of oral debriefing enables its execution and offers quality to the nursing process.

Inspiring Empathy and Policy Action in Undergraduate Students: Monopoly as a Strategy.

Baccalaureate-prepared nurses report low levels of confidence and fail to view policy-level advocacy as an essential role of the nurse. Innovations in baccalaureate curricula intended to bolster empathy with regard to vulnerable groups and to increase awareness of the advocacy role are essential. Cross-sectional descriptive methods were used to explore the impact of a modified version of the game Monopoly-created to simulate a social environment of socioeconomic disadvantage-on nursing student perspectives of advocacy. Data were analyzed from oral debriefing and written reflections following the exercise. A content analysis was performed that revealed themes of Awareness, Emotional Response, Empathy, and Advocacy. This exercise challenged student perspectives and ultimately enhanced awareness, empathy, and intent to advocate for socioeconomically disadvantaged groups. [J Nurs Educ. 2019;58(5):298-301.].

Peer-Led Written Debriefing Versus Instructor-Led Oral Debriefing: Using Multimode Simulation

BackgroundInstructor-led oral debriefing (ILOD) conveys accurate knowledge but requires highly trained experts. This study evaluated nursing students' knowledge and confidence of preoperative nursing skills and their satisfaction with debriefing and simulation using peer-led written debriefing (PLWD) and instructor-led debriefing. MethodTo compare and analyze effects of PLWD and ILOD using multimode simulation, participants were randomly divided into two groups: PLWD (n = 60) and ILOD (n = 62). ResultsNo significant differences in the total knowledge score, satisfaction with multimode simulation, or satisfaction on debriefing between PLWD and ILOD were found. ConclusionsPLWD may be as effective as an ILOD and could improve resource utilization and feasibility. However, the method of PLWD for this study is useful for basic skill scenarios, in particular, and may not be applicable in all scenarios.

Comparison of the effects of debriefing methods on psychomotor skills, self-confidence, and satisfaction in novice nursing students: A quasi-experimental study.

Oral debriefing (OD) and video-assisted debriefing (VAD) are commonly used debriefing methods, with no evidence of superiority of one to another. The present study aimed to compare the effects of OD and VAD on the development of learning outcomes in nursing students. This is a quasi-experimental study. A total of 50 first-year nursing students participated in this study. Participants in the control group participated in OD and those in the intervention group took part in VAD. Debriefing improved psychomotor skills, self-confidence, and student satisfaction in both groups. There was no statistically significant difference between OD and VAD in the study outcomes. Both OD and VAD methods have significantly positive impact on simulation outcomes and can increase preparedness of nursing students before entering the clinical settings. Given the widespread use of simulation, more studies are needed to evaluate different methods of debriefing to optimize the usefulness of simulation-based learning.

Comparing Effectiveness of Video-Assisted Oral Debriefing versus Oral Debriefing Alone During Human Resuscitation Simulation: A Randomized Trial

Aim of the study: Debriefing is central to simulation-based education. As its optimal format is unknown, video-feedback may optimize the learning process. The purpose of the study was to evaluate the potential benefits of videoassisted oral debriefing (VAOD) versus oral debriefing alone (ODA) for improving performance in a Basic Life Support with an Automated External Defibrillator (BLS/ AED) scenario. Methods: One hundred and forty candidates (physicians and nurses) were enrolled in the study. After performing a pretest scenario, participants were randomized into two groups to receive a facilitated debriefing: either ODA or VAOD. Participants were then asked to complete a posttest scenario. Pre- and posttests were video recorded to allow a blinded independent reviewer to rate each participant’s skills in both tests, using the European Resuscitation Council BLS/AED provider assessment record tool. Results: Overall BLS/AED resuscitation performance scores improved in both groups [mean (SD), 57.08% (1.77%) for ODA pretests vs. 89.77% (2.15%) for ODA posttests (p<0.001); 64.31% (2.54%) for VAOD pretests vs. 91.15% (3.08%) for VAOD posttests (p=0.06)]. Score improvement was not found to be very different between the two groups (+33% for ODA vs. +27% for VAOD, p=0.06). Conclusion: Using VAOD in human resuscitation simulation did not show any advantage over ODA and did not enhance its impact on the participants’ perception. However, our results suggested that the use of a debriefing process (either oral or video-assisted) contributes to a significant improvement in resuscitation skills.

Effects of Video-Assisted Debriefing Compared with Standard Oral Debriefing

BackgroundVideo playback during debriefing is a frequent recommendation to develop skillful practice; however, research shows no clear benefit. MethodA randomized controlled trial was conducted to determine the effects of type of debriefing on psychophysiological stress responses and performance of nursing students in a repeated simulation after approximately two weeks. ResultsCompared with oral debriefing, video-assisted debriefing had no significant effect on the psychophysiological stress responses and performance. Across sessions, state anxiety significantly decreased and performance score improved. ConclusionReduced psychological stress and improved performance found in the repeat exposure validate the usefulness of simulation-based education to foster practice-based learning.

Comparison of oral and video debriefing and its effect on knowledge acquisition following simulation-based learning.

Learning from simulation takes place to a large extent in debriefing; however, there is still sparse knowledge about the advantages and disadvantages of debriefing methods. 2 common forms are video-assisted and oral only debriefing. We set out to determine if there is increased knowledge acquisition for candidates undergoing video, rather than oral debriefing. Second year doctors were randomised to a training day with oral or video feedback. Candidates underwent an emergency clinical scenario followed by feedback. The candidates completed 30 multiple choice questions related to managing common clinical emergencies presimulation and postsimulation training. There was no significant difference in the postscore mean for the oral debriefing (128.3, SD 5.16) and video-assisted debriefing group (127.1, SD=5.96). There was significant interaction between precourse and postcourse scores with superior knowledge acquisition for candidates with lower precourse scores (p=0.008). The candidates with lowest precourse score showed significant improvement in the orally debriefed group in comparison to video debriefed group. Our results showed that video debriefing has equivocal effect to oral debriefing. Oral debriefing provides superior knowledge acquisition to learners with lower precourse test scores.

Simulated settings; powerful arenas for learning patient safety practices and facilitating transference to clinical practice. A mixed method study.

Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n=262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice.

Comparing effectiveness of video-assisted oral debriefing versus oral debriefing alone during human resuscitation simulation: A randomized trial

Purpose of the Study: Debriefing is an important key component of simulation-based medical education. As its optimal format is unknown, video-feedback may optimize the learning process. The purpose of the study was to evaluate the potential benefits of video-assisted oral debriefing (VAOD) versus oral debriefing alone (ODA) on candidates’ performance in a Basic Life Support with an Automated External Defibrillator (BLS/AED) scenario. We also evaluated the candidates’ perception about the usefulness of either debriefing.

Comparison of Baccalaureate Nursing Students' Experience of Video-Assisted Debriefing versus Oral Debriefing following High-Fidelity Human Simulation

High-Fidelity Human Simulation (HFHS) is used in many disciplines, including nursing, as an innovative teaching pedagogy that offers an active learning process. The simulation process involves a number of stages with the most critical stage identified as debriefing. The main focus of debriefing is to stimulate reflection and encourage communication while exploring the emotions of the participants. These emotions assist in framing the experience that aids in enhancement of learning for the student. This quantitative, quasi-experimental study explored the comparison of two debriefing processes, video-assisted and oral, by assessing the students' opinion of the debriefing experience and the students' rating of the importance of the debriefing experience. Participants were first semester baccalaureate nursing students. The overall finding and the four subscales for both dependent variables showed no statistical significance. This article provides further evidence to guide educators to a preferred method of debriefing students after a simulated experience.

Comparing the effectiveness of video-assisted oral debriefing and oral debriefing alone on behaviors by undergraduate nursing students during high-fidelity simulation

Complex healthcare, less resources, high-level medical equipment, and fewer available clinical settings have led many health professionals to use simulation as a method to further augment educational experiences for nursing students. While debriefing is recommended in the literature as a key component of simulation, the optimal format in which to conduct debriefing is unknown. This pre- and posttest two-group randomized quasi-experimental design compared the effectiveness of video-assisted oral debriefing (VAOD) and oral debriefing alone (ODA) on behaviors of 48 undergraduate nursing students during high-fidelity simulation. Further, this study examined whether roles (e.g., team leader, medication nurse), type of scenarios (i.e., pulmonary and cardiac scenarios), and student simulation team membership (i.e., VAOD and ODA groups) influenced these behaviors. Behaviors observed in this study related to patient safety, communication among team members, basic- and problem-focused assessment, prioritization of care, appropriate interventions, and delegation to healthcare team members. Both human patient simulator practice and guidance using video-assisted oral debriefing and oral debriefing alone appeared to be comparable regarding behaviors, regardless of roles, type of scenarios, and student simulation team membership. These findings suggest that nurse educators may use either video-assisted oral debriefing or oral debriefing alone to debrief undergraduate nursing students during high-fidelity simulation.

Using Debriefing to Foster Task Management among Anesthesiologist Assistant Students

Purpose: This study evaluated the effect of video-aided oral debriefing on task management of anesthesiologist assistant students through the use of high-fidelity anesthesia crisis simulation scenarios. This information describes an evaluation of student learning that is valuable in student educational and workplace competency. Method: A total of 18 graduate students in an anesthesiologist assistant program voluntarily participated in two anesthesia simulation scenarios separated by one of two debriefing methods (oral debriefing versus video-aided oral debriefing). Task management scores of the scenarios were assessed through the Anesthetists’ Nontechnical Skills system. Task management scores after the pre-intervention scenario were compared to the scores after the post-intervention scenario. The effectiveness of video-aided oral debriefing was studied using a within-subjects analysis. The comparison of video-aided oral debriefing to oral debriefing was examined with a between-subjects analysis. Results: The results showed a significant improvement in the intervention group from the initial assessment to the subsequent assessment in task management (p&lt;0.001). However, results did not show a statistically significant difference between the two debriefing methods after a second anesthesia crisis scenario (p=0.21). Conclusion: The research study found that task management during anesthesia crisis scenarios improved after video-aided oral debriefing. No difference was found when comparing the improvement in task management between debriefing methods. Therefore, video-aided oral debriefing was comparable to oral debriefing in improving task management in this study.

Playing With Conflict

Playing With Conflict is a weekend course for graduate students in Portland State University’s Conflict Resolution program and undergraduates in all majors. Students participate in simulations, games, and experiential exercises to learn and practice conflict resolution skills. Graduate students create a guided role-play of a conflict. In addition to an oral debriefing, students wrote a debriefing report following the Description, Interpretation, Evaluation (DIE) model of debriefing. The written debriefing report gave all students an opportunity to reflect, analyze, and evaluate their experience in depth. The use of two facilitators allows one to facilitate while the other observes and rests, makes 2 points of view available for the debriefing, and offers a model for resolving minor disagreements between them. Trust among students increased across the weekend as evidenced by an increase in cooperative choices and estimates of the likelihood that others would cooperate in the TAKE-A-CHANCE game, a version of PRISONER’S DILEMMA. Most reported having fun while they learned about themselves, interpersonal conflict, and some large-scale social conflicts.

Deficits in the Provision of Cardiopulmonary Resuscitation During Simulated Obstetric Crises

Cardiac arrest in the parturient is often fatal, but appropriate resuscitation in this special situation may save the lives of the mother and/or unborn baby. Concern has arisen as to application of recommended techniques for resuscitation in the obstetric patient. The Israel Board of Anesthesiology has incorporated simulation assessment into accreditation examinations. The candidates represent a unique national cohort in which we were able to assess competence in the simulated scenario of cardiorespiratory arrest in the parturient. METHODS A simulated scenario of preeclampsia with magnesium toxicity leading to cardiac arrest in a pregnant patient was performed by 25 senior anesthesiology residents. A unique two-stage simulation examination consisting of high fidelity simulation followed immediately by oral debriefing was conducted. The assessment was scored using a predetermined checklist of key actions and answers to clarifying questions. Simulation performance was compared to debriefing performance. RESULTS During the board examination, resuscitation not specific to the pregnant patient was performed well (commencing chest compressions, bag-mask ventilation, cardiac defibrillation); however actions specific to the parturient were performed poorly. Left uterine displacement, cricoid pressure during bag-mask ventilation, and instructing preparations to be made for perimortem cesarean delivery within 5 minutes were performed by 68%, 48%, and 40% of candidates respectively (lower 99% confidence limit 42%, 25%, and 19%, respectively). Cricoid pressure during bag-mask ventilation was performed by 48% (25%) but described in debriefing by 80% of candidates (53%) (P = 0.08), and time setting for perimortem cesarean delivery was performed by 40% (29%) but described by 80% (53%) (P = 0.05) of examinees. CONCLUSIONS Senior anesthesiology residents have poor knowledge of resuscitation of the pregnant patient. The results suggest 2-stage simulation including an oral component may reveal disparities in knowledge not assessed by simulation alone, but definitive conclusions require further study.

The Effectiveness of Video-Assisted Debriefing Versus Oral Debriefing Alone at Improving Neonatal Resuscitation Performance

Debriefing is a critical component of effective simulation-based medical education. The optimal format in which to conduct debriefing is unknown. The use of video review has been promoted as a means of enhancing debriefing, and video-assisted debriefing is widely used in simulation training. Few empirical studies have evaluated the impact of video-assisted debriefing, and the results of those studies have been mixed. The objective of this study was to compare the effectiveness of video-assisted debriefing to oral debriefing alone at improving performance in neonatal resuscitation. Thirty residents, divided into 15 teams of 2 members each, participated in the study. Each team completed a series of 3 neonatal resuscitation simulations. Each simulation was followed by a facilitated debriefing. Teams were randomly assigned to receive either oral debriefing alone or video-assisted debriefing after each simulation. Objective measures of performance and times to complete critical tasks in resuscitation were evaluated by blinded video review on the first (pretest) and the third (posttest) simulations using a previously validated tool. Overall neonatal resuscitation performance scores improved in both groups [mean (SD), 83% (14%) for oral pretest vs. 91% (7%) for oral posttest (P = 0.005); 81% (16%) for video pretest vs. 93% (10%) for video posttest (P < 0.001)]. There was no difference in performance scores between the 2 groups on either the pretest or posttest [overall posttest scores, 91.3% for oral vs. 93.4% for video (P = 0.59)]. Times to complete the critical tasks of resuscitation also did not differ significantly between the 2 study groups. The educational effect of the video-assisted debriefing versus oral debriefing alone was small (d = 0.08). Using this study design, we failed to show a significant educational benefit of video-assisted debriefing. Although our results suggest that the use of video-assisted debriefing may not offer significant advantage over oral debriefing alone, exactly why this is the case remains obscure. Further research is needed to define the optimal role of video review during simulation debriefing in neonatal resuscitation.

Using Video-Facilitated Feedback to Improve Student Performance Following High-Fidelity Simulation

Background This pilot study evaluated the effect of videotape-facilitated human patient simulator (HPS) practice and guidance on clinical performance indicators. Method Nursing and nurse anesthetist students in the treatment group ( n = 20) participated in HPS practice and guidance using videotape-facilitated debriefing, and the control group ( n = 20) participated in HPS practice and guidance using oral debriefing alone. Results Students in the intervention group were significantly more likely to demonstrate desirable behaviors concerning patient identification, team communication, and vital signs. The role students played in the simulation significantly impacted their performance. When scores of both the intervention and control groups were combined, team leaders, airway managers, and nurse anesthetists had higher mean total performance scores than crash cart managers, recorders, or medication nurses. Conclusion Video-facilitated simulation feedback is potentially a useful tool in increasing desirable clinical behaviors in a simulated environment.

Personalized Oral Debriefing Versus Standardized Multimedia Instruction After Patient Crisis Simulation

Simulation experience alone without debriefing is insufficient for learning. Standardized multimedia instruction has been shown to be useful in teaching surgical skills but has not been evaluated for use as an adjunct in crisis management training. Our primary purpose in this study was to determine whether standardized computer-based multimedia instruction is effective for learning, and whether the learning is retained 5 wk later. Our secondary purpose was to compare multimedia instruction to personalized video-assisted oral debriefing with an expert. Thirty anesthesia residents were recruited to manage three different simulated resuscitation scenarios using a high-fidelity patient simulator. After the first scenario, subjects were randomized to either a computer-based multimedia tutorial or a personal debriefing of their performance with an expert and videotape review. After their respective teaching, subjects managed a similar posttest resuscitation scenario and a third retention test scenario 5 wk later. Performances were independently rated by two blinded expert assessors using a previously validated assessment system. Posttest (12.22 +/- 2.19, P = 0.009) and retention (12.80 +/- 1.77, P < 0.001) performances of nontechnical skills were significantly improved in the standardized multimedia instruction group compared with pretest (10.27 +/- 2.10). There were no significant differences in improvement between the two methods of instruction. Computer-based multimedia instruction is an effective method of teaching nontechnical skills in simulated crisis scenarios and may be as effective as personalized oral debriefing. Multimedia may be a valuable adjunct to centers when debriefing expertise is not available.