Simulation-based Course Research Articles

Development of a3Dprinted simulator for closed reduction of distal radius fractures.

BackgroundThe use of simulators in medical education is critical for developing procedural competence prior to treating patients. Current training of emergency physicians to perform distal radius fracture reduction is inconsistent and inadequate.ApproachWe developed a 3D printed distal radius fracture simulation training model that is easy to assemble and relatively inexpensive. We present step-by-step instructions to reproduce the model.EvaluationThe model was found to have high fidelity for training by both instructors and participants in a simulation-based mastery learning course.ReflectionWe successfully designed a low cost, easy to reproduce, high fidelity model for use in a simulation-based mastery learning course to teach distal radius fracture reduction.Electronic supplementary materialThe online version of this article (10.1007/s40037-020-00609-w) contains supplementary material, which is available to authorized users.

Evaluating a Multimodal Clinical Anesthesia Course Integrated Into an Existing Veterinary Curriculum.

This study evaluated a multimodal, simulation-based course in veterinary anesthesia integrated into an existing veterinary curriculum. A simulation-based, multimodal training course in clinical anesthesia was evaluated using outcomes from multiple levels of the Kirkpatrick Model of Training Evaluation. Cognitive and affective outcomes were evaluated before and after instruction. Head-mounted cameras were used to record clinical performance during students' first live patient anesthesia experience in the curriculum. Pretest-posttest analysis of cognitive and affective outcomes for course participants revealed significant increases in knowledge and self-efficacy. Course participants received higher ratings on clinical task performance and professional skills (ie, communication and collaboration) compared with a matched control group when evaluated by blinded, external raters using a standardized rubric. These findings indicate that implementing a multimodal anesthesia simulation-based course directly into the curriculum can enhance cognitive and affective outcomes and prepare students for subsequent anesthesia-related patient care experiences.

Mind the gap: The integration of anatomy course contents with basic procedural skills

ObjectivesThis study investigated the value of procedural skill acquisition in low-fidelity simulation labs for students entering a clinical setting during the mandatory one-month nursing internship. MethodsWe conducted a course that combined gross anatomy knowledge with the teaching of simple procedural skills. We analysed 299 students' opinions and then compared them with their assessment outcomes. ResultsThe survey results showed general satisfaction of students with the simulation-based course. Regarding the role of procedural labs as an adequate enhancement for traditional anatomy labs, students considered the basic procedural skills course as a strong alternative for traditional anatomy lectures and labs. Moreover, a comparison of participants' pre- and post-course answers indicated a significant increase in their anatomy knowledge. ConclusionsThis study thus indicated a positive perception of students about a course that employed innovative educational measures. In this way, the positive impact of teaching anatomical knowledge through basic procedures was noted.

Development, implementation, and outcomes of a simulation-based medical education (SBME) prostate brachytherapy workshop for radiation oncology residents

PurposeDespite a preponderance of data demonstrating strong clinical outcomes and cost-effectiveness, prostate brachytherapy use and competency continue to decline. Enhanced resident education may help reverse this trend. We therefore developed and implemented a simulation-based medical education course for low-dose-rate prostate brachytherapy (LDR-PB). Materials and MethodsA 1-week LDR-PB course comprised four 1-h lectures on clinical outcomes, physics, radiobiology, and anatomy/contouring, followed by a 4.5-h simulation session on ultrasound-guided prostate phantom implantation, was developed for radiation oncology residents at an academic institution. A 10-statement Likert-scale survey and 20-question multiple-choice test were administered 1 week before and 4 weeks after the course. ResultsPrecourse and postcourse instruments were completed by 24 and 20 residents, respectively. The median number of prior LDR-PB cases after at least one genitourinary rotation was 10.5 (range 5–20). Overall mean test scores were significantly improved (55% before the course vs 68% after the course; p = 0.010). Mean Likert scores significantly increased on nine of 10 survey statements and were significantly increased overall (2.4 before the course vs 3.3 after the course, p < 0.001). When asked about interest in performing brachytherapy after residency, 37.5% of residents “agreed” or “strongly agreed” before the course vs 50% after the course (p = 0.41). Those with higher postresidency brachytherapy interest (scores of 4–5 vs 1–3) had significantly more LDR-PB cases (11.2 vs 5.3 cases; p = 0.005). ConclusionsA 1-week simulation-based medical education course for LDR-PB can improve didactic performance and self-reported technical competence/confidence, and may increase overall enthusiasm for brachytherapy. Future studies at our institution will incorporate evaluation of implant quality and assessment of procedural competence into this framework. Residency programs should dedicate resources to this essential component of radiation oncology.

Content validity evidence for a simulation-based test of handheld otoscopy skills.

At graduation from medical school, competency in otoscopy is often insufficient. Simulation-based training can be used to improve technical skills, but the suitability of the training model and assessment must be supported by validity evidence. The purpose of this study was to collect content validity evidence for a simulation-based test of handheld otoscopy skills. First, a three-round Delphi study was conducted with a panel of nine clinical teachers in otorhinolaryngology (ORL) to determine the content requirements in our educational context. Next, the authenticity of relevant cases in a commercially available technology-enhanced simulator (Earsi, VR Magic, Germany) was evaluated by specialists in ORL. Finally, an integrated course was developed for the simulator based on these results. The Delphi study resulted in nine essential diagnoses of normal variations and pathologies that all junior doctors should be able to diagnose with a handheld otoscope. Twelve out of 15 tested simulator cases were correctly recognized by at least one ORL specialist. Fifteen cases from the simulator case library matched the essential diagnoses determined by the Delphi study and were integrated into the course. Content validity evidence for a simulation-based test of handheld otoscopy skills was collected. This informed a simulation-based course that can be used for undergraduate training. The course needs to be further investigated in relation to other aspects of validity and for future self-directed training.

Reclaiming Hands-on Ultrasound for Radiology With a Simulation-Based Ultrasound Curriculum for Radiology Residents.

Hands-on ultrasound training is included in the curriculum of many medical specialties and is increasingly incorporated into medical school curricula. Despite published curricula for ultrasound training in these specialties, there remains a dearth of such programs for radiology residency programs. At our institution, there has been a perceived decline in ultrasound scanning comfort and skill in trainees. The purpose of this project was to assess the utility and efficacy of a hands-on simulation-based ultrasound course for radiology residents.First-year radiology residents were enrolled in a 2-week simulation-based course for the instruction of hands-on ultrasound training. With the use of a customizable commercial simulation software platform, residents completed didactic modules, virtual simulations, and phantom scans for a 2-week rotation. A dedicated simulation center with scanning models and computer-based software was provided to all residents. Self-assessments and assignments provided benchmarks of performance. All radiology residents were surveyed at the start of the academic year to assess prior experience and comfort with ultrasound scanning. First-year residents were surveyed a second time upon course completion.Presurvey and postsurvey responses suggest that participation in the 2-week ultrasound scanning course contributed to an improvement in perceived scanning knowledge and comfort for participating residents. Based on our initial experience, the scanning curriculum presented here provides a comprehensive introductory course for first-year radiology residents both for ultrasound anatomy and for scanning technique. Continued education in hands-on ultrasound skills is a crucial factor in maintaining radiology's dominance in the modality.

Using simulation to help healthcare professionals relaying patient information during telephone conversations

BackgroundThe purpose of this paper is to describe a development project in which simulation was used to improve the telephone-based conversations between nurses in an emergency department (ED) and physicians from different specialties taking care of acutely ill patients. MethodsA needs analysis consisting of observations and interviews was conducted and a one-day simulation-based interprofessional team training course was developed. Observations of phone conversations pre-course, three and six months after the course were conducted in the clinical setting with 20 participants in each point of time. A 14-item evaluation tool was used to record how many information pieces were communicated. ResultsFive courses were conducted for 66 nurses/nurse assistants and 17 physicians. 9 out of the 14 items were reported significantly more after the course. Item that were not reported in the pre-measurement, increased to around 20% reporting three months after the course but then fell to close to 0% again after six months. ConclusionsThe patterns of retention and decrease of the effect could be an indicator for norms, values and beliefs held by professions about what constitutes their task.

Simulation-Based Course Improves Resident Comfort, Knowledge, and Ability to Manage Surgical Intensive Care Unit Patients

BackgroundSimulation-based education can augment residents' skills and knowledge. We assessed the effectiveness of a simulation-based course for surgery interns designed to improve their comfort, knowledge, and ability to manage common surgical critical care (SCC) conditions. Materials and methodsFor 2 y, all first year residents (n = 31) in general surgery, urology, interventional radiology, and the integrated plastics, vascular, and cardiothoracic surgery training programs at our institution participated in a simulation-based course emphasizing evidence-based management of SCC conditions. Precourse and postcourse surveys and multiple-choice tests, as well as summative simulation tests, assessed interns' comfort, knowledge, and ability to manage SCC conditions. Changes in these measures were assessed with Wilcoxon matched-pairs signed rank tests. Factors associated with summative performance were determined by linear regression. ResultsThe course consisted of four simulation-based teaching sessions in year 1 and six in year 2. The course taught seven of the 18 core SCC conditions in the Surgical Council on Resident Education general surgery curriculum in year 1 and 10 in year 2. Interns' self-reported comfort, knowledge, and ability to manage each condition taught in the course increased (P < 0.02). Their knowledge of each condition, as assessed by written tests, also increased (P < 0.02). Their summative simulation test performance correlated with the number of course sessions attended (P < 0.03) and status as general surgery residents (P < 0.01). ConclusionsA simulation-based SCC training course for surgery interns that emphasizes evidence-based management of SCC conditions improves interns' comfort, knowledge, and ability to manage these conditions.

The evolution of a national, advanced airway management simulation-based course for anaesthesia trainees.

Needs analyses involving patient complaints and anaesthesiologists' confidence levels in difficult airway management procedures in Denmark have shown a need for training in both technical and non-technical skills. To provide an example of how to design, implement and evaluate a national simulation-based course in advanced airway management for trainees within a compulsory, national specialist training programme. A national working group, established by the Danish Society for Anaesthesiology and Intensive Care Medicine, designed a standardised simulation course in advanced airway management for anaesthesiology trainees based on the six-step approach. Learning objectives are grounded in the curriculum and analyses-of-needs (in terms of knowledge, skills and attitudes, including non-technical skills, which encompass the cognitive skills and social skills, necessary for safe and effective performance). A total of 28 courses for 800 trainees have been conducted. Evaluation has been positive and pre and posttests have indicated a positive effect on learning. The course was successfully designed and implemented within the national training programme for trainees. Important factors for success were involvement of all stakeholders, thorough planning, selection of the most important learning objectives, the use of interactive educational methods and training of the facilitators.

Everything is about the story

Everything in life is about the story, from our every day, our holidays and trips, to going to the theater or the movies. Everything is about the story and attending a simulation-based course is not the exception. From designing and living, a scenario all the way to debriefing and to the whole course experience at the end the participant will take away the story, will remember the story and will share the story. This story has to be designed to the details, has to be told through languages and has an objective centered on the learner. In this reflection, I discuss with the reader my opinion regarding the relevance of creating a memorable story because at the end it is all about the story.

Bridging the Gap: Using Interspecialty High-Fidelity Simulation to Improve Skills in Adolescent Emergency Medicine.

Adolescents are attending emergency departments (EDs) in increasing numbers, accounting for 21% attendances in the United Kingdom. A recent report by the Northern Ireland Commissioner for Children and Young People highlighted deficiencies in the support offered by EDs to adolescents. The aim of this study was to develop a high-fidelity simulation-based course focused on managing common adolescent presentations to the ED. A 1-day mixed-modality course comprising of simulations, lectures, and skill stations, mapped to the pediatric and emergency medicine curriculum, was designed. The faculty developed and delivered 8 high-fidelity simulations. Precourse and immediate postcourse questionnaires were used to assess confidence levels and gain qualitative data. Delayed feedback was collected at 3 months. There were 36 participants; 86% (n = 31) completed the precourse feedback, 96% (n = 34) completed the postcourse feedback, and 47% (n = 17) completed the delayed feedback. There was a statistically significant increase in self-reported confidence across all domains with a median increase of 21.25% immediately, sustained at 20% on delayed 3-month feedback. Qualitative feedback noted a change in practice, "I used (the knowledge) regularly while working in children's A + E." This was a feasible, high-fidelity simulation-based study day covering the key components of adolescent medicine. The sustained increase in confidence at 3 months and the positive qualitative and quantitative feedback are supportive of the use of simulation to improve adolescent emergency care.

Participation in a System-Thinking Simulation Experience Changes Adverse Event Reporting.

System failures are contributing factors in the thousands of adverse events occurring in US healthcare institutions yearly. This study explored the premise that exposure to a simulation experience designed to improve system thinking (ST) would impact adverse event reporting patterns. An intervention-control study was used to explore impacts of participation in a simulation designed to improve ST on adverse event reporting. Each summer Bachelor in Nursing Science students along with medical students participate in a week-long simulation-based interprofessional patient safety course. During the 2017 course, Friday Night in the ER, a table-top simulation designed to develop ST was included. As part of the school nursing's simulation program, students are asked to report adverse events observed or committed during simulation encounters into a simulated adverse event reporting system outside the simulation-based interprofessional patient safety course. Adverse event reporting system data were used to examine patterns of adverse event reporting in control and intervention groups studied. Findings demonstrated differences in proportions of reported adverse events. The proportion of reported adverse events by students with the second and terminal semesters of course work combined and the 2016 and 2018 control groups combined demonstrated statistically significant differences, P < 0.001. Additional analysis revealed that the intervention group reported more medication-related events, whereas the control group reported more failure to rescue and airway-related events. Exposure to a simulation designed to develop ST seems to impact adverse event reporting. These findings support the idea that ST may change safety monitoring behaviors.

Team performance training for medical students: Low vs high fidelity simulation

ObjectivesThe aim of this study is to evaluate a simulation-based team performance course for medical students and compare its low- and high-fidelity components. Study designThis is a prospective crossover observational study. Groups participated in one low- and one high-fidelity session twice. Low-fidelity scenarios included management of an emergency case on a simulated-patient, whereas high-fidelity scenarios constituted of multiple-trauma cases where simulated-patients wore a hyper-realistic suit. Team performance was assessed objectively, using the TEAM™ tool, and subjectively using questionnaires. Questionnaires were also used to assess presence levels, stress levels and evaluate the course. ResultsParticipants’ team performance was higher in the low-fidelity intervention as assessed by the TEAM™ tool. An overall mean increase in self-assessed confidence towards non-technical skills attitudes was noted after the course, however there was no difference in self-assessed performance between the two interventions. Both reported mean stress and presence levels were higher for the high-fidelity module. Evaluation scores for all individual items of the questionnaire were ≥4.60 in both NTS modules. Students have assessed the high-fidelity module higher (4.88 out of 5, SD = 0.29) compared to low-fidelity module (4.74 out of 5, SD = 0.67). ConclusionsBoth the low- and high-fidelity interventions demonstrated an improvement in team performance of the attending medical students. The high-fidelity intervention was more realistic, yet more stressful. Furthermore, it proved to be superior in harvesting leadership, teamwork and task management skills. Both modules were evaluated highly by the students, however, future research should address retention of the taught skills and adaptability of such interventions.

Development and evaluation of asimulation-based transition to clerkship course.

BackgroundTransition to clerkship courses bridge the curricular gap between preclinical and clinical medical education. However, despite the use of simulation-based teaching techniques in other aspects of medical training, these techniques have not been adequately described in transition courses. We describe the development, structure and evaluation of a simulation-based transition to clerkship course.ApproachBeginning in 2012, our institution embarked upon an extensive curricular transformation geared toward competency-based education. As part of this effort, a group of 12 educators designed, developed and implemented a simulation-based transition course. The course curriculum involved seven goals, centered around the 13 Association of American Medical Colleges Core Entrustable Professional Activities for entering residency. Instructional techniques included high-fidelity simulation, and small and large group didactics. Student competency was determined through a simulation-based inpatient-outpatient objective structured clinical examination, with real-time feedback and remediation. The effectiveness of the course was assessed through a mixed methods approach involving pre- and post-course surveys and a focus group.EvaluationOf 166 students, 152 (91.6%) completed both pre- and post-course surveys, and nine students participated in the focus group. Students reported significant improvements in 21 out of 22 course objectives. Qualitative analysis revealed three key themes: learning environment, faculty engagement and collegiality. The main challenge to executing the course was procuring adequate faculty, material and facility resources.ReflectionThis simulation-based, resource-heavy transition course achieved its educational objectives and provided a safe, supportive learning environment for practicing and refining clinical skills.Electronic supplementary materialThe online version of this article (10.1007/s40037-020-00590-4) contains supplementary material, which is available to authorized users.

Introduction of a patient communication course to postgraduate oncology training in Russia.

11022 Background: Communication skills are an obligatory part of postgraduate oncology education in European and Western countries and its benefits for doctors, patients, and the healthcare system are well-known. However, teaching efficient patient communication is challenging in developing countries where the paternalistic model is still spread and medical professionals are unaware that these skills are lacking. We hypothesize that a short simulation-based course for oncology residents introduces communication skills and raises awareness about its value. Methods: A 2-day communication course based on the Calgary-Cambridge model was taught to a cohort of PGY2 oncology residents. Lectures, seminars, and clinical simulations emphasizing a patient-centered approach, including open questions, active listening, identifying patient concerns, empathy, summarizing, and bad news delivery were conducted by certified teacher. A simulation exam was administered to those who completed the communication course and those who did not complete the course. Scores (max. 130) from two clinical scenarios assessed by the examiner, actors, and participant were compared between groups. Results: Ten PGY2 residents completed the course and seven did not complete the course. Medians scores for the first scenario given by the examiner, actor and resident were 99 (IQR: 90 – 122), 125 (IQR: 122 – 127) and 102 (IQR: 91 – 108) for course participants and 15 (IQR: 7-35), 18 (IQR: 12-34) and 61 (IQR: 41-83) for non-participants, respectively. Medians scores for the second scenario were also higher in participant group: 113.5 (IQR: 100-117), 107 (IQR: 98-118) and 104 (IQR: 99-112) vs. 22 (IQR: 12-50), 18 (IQR: 10 - 44) and 66 (IQR: 43-81), respectively. Four (40%) course participants and seven (100%) non-participants evaluated themselves higher than the examiner and actor. Conclusions: A short patient communication course for young oncologists effectively improves communication skills and provider self-awareness in developing countries.

A prospective study integrating a curriculum of interventional radiology in undergraduate education: a tetra-core simulation model

BackgroundInterventional radiology (IR) is underrepresented in undergraduate medical curricula across Europe. By continuing to challenge the boundaries of IR, a rise in the demand for radiologists has been inevitable – a trend not met by a corresponding rise in the supply of radiologists. On tracing the roots of this shortage, lack of awareness of the specialty within medical trainees coupled with a global lack of IR teaching in undergraduate education seem to constitute major exacerbating factors. The purpose of this study was to identify gaps in the field of IR education and address these by implementing an international IR simulation-based course for undergraduates.ResultsImplementation of a multi-modality simulation-based course consisted of seven modules incorporating technical and non-technical skills, basic science and applied clinical science modules. Of all participants, 90.7% (N = 68) never had previous IR teaching experience and only 28% (N = 21) had a previous placement in an IR department. Following the course, confidence improvement was statistically significant both in IR skills (1/5, p < 0.01) and knowledge (1/5, p < 0.01)]. The majority (90.7%) said they would benefit with more exposure to IR. In terms of the students’ motivation for a career in IR, 32% (N = 24) reported that they would more likely consider a career in IR after completing the course.ConclusionDelivery of a tetra-core simulation course with the aim to address the gaps in undergraduate IR education has had a positive impact on students’ skills, confidence levels as well as motivation. We propose reviewing the curricula across medical schools in Europe to identify gaps and address any inadequacies; for this, we consider our simulation course an excellent starting point.

What participants learn, with, from and about each other during inter-professional education encounters: A qualitative analysis

BackgroundSafe healthcare requires teamwork and collaboration. To meet the needs of healthcare organizations and professionals, inter-professional education, is no longer an optional educational trend but rather a mandate of accrediting health education agencies. ObjectiveIn an effort to better understand the impact of inter- professional educational activities, this study sought to explore via qualitative methods what nursing and medical students learn with, from, and about one another during a week - long simulation-based inter-profession education course. DesignA convenience sample of post-course survey responses from students participating in a week-long, inter-professional, simulation-based patient safety course was used to longitudinally explore what participants learn with, from, and about each other. SettingsThe setting for this study was a research university located in the southeast United States. ParticipantsThe participants included a total of 272 second semester accelerated option Bachelor of Nursing students and 599 medical students entering the 3rd year of their program that participated in an annual patient safety course. The study analyzed responses of students to questions in a post-course survey regarding educational outcomes while learning with students from a different profession. ResultsIn the responses from 871 students collected over four years, the following key themes emerged. Students: 1) articulated learning the importance of contributions of other professions to the healthcare team, 2) expressed an appreciation for areas where their colleagues' training was superior to their own; and 3) identified deficiencies in their own knowledge and skill sets. ConclusionThe findings of this study provide a basis for developing more specific curricular content as part of inter-professional education endeavors to strengthen constructive views of healthcare professions, foster a more collaborative shared mental model, and to correct perceived misconceptions.

Outcomes Associated With Insertion of Indwelling Urinary Catheters by Medical Students in the Operating Room Following Implementation of a Simulation-Based Curriculum.

Catheter-associated urinary tract infection (CAUTI) is a priority quality metric for hospitals. The impact of placement of indwelling urinary catheter (IUC) by medical students on CAUTI rates is not well known. This study examined the impact of a simulation-based medical student education curriculum on CAUTI rates at an academic medical center. Patient characteristics, procedural data, and outcome data from all operating room IUC insertions from June 2011 through December 2016 at the Northwestern University Feinberg School of Medicine were analyzed using a multivariable model to evaluate associations between CAUTI and inserting provider. Infection data before and after implementation of a simulation-based IUC competency course for medical students were compared. A total of 57,328 IUC insertions were recorded during the study period. Medical students inserted 12.6% (7,239) of IUCs. Medical students had the lowest overall rate of CAUTI among all providers during the study period (medical students: 0.05%, resident/fellows: 0.2%, attending physicians: 0.3%, advanced practice clinicians: 0.1%, nurses: 0.2%; P = .003). Further, medical student IUC placement was not associated with increased odds of CAUTI in multivariable analysis (odds ratio, 0.411; 95% confidence interval: 0.122, 1.382; P = .15). Implementation of a simulation-based curriculum for IUC insertion resulted in complete elimination of CAUTI in patients catheterized by medical students (0 in 3,471). IUC insertion can be safely performed by medical students in the operating room. Simulation-based skills curricula for medical students can be effectively implemented and achieve clinically relevant improvements in patient outcomes.

A retrospective cohort study of the impact of In Time obstetric simulation training on management of vaginal breech deliveries.

Following the Term Breech Trial, vaginal breech deliveries are rarely undertaken in Australia. Some women choose to have a breech delivery following counselling, while others will present in labour with an undiagnosed breech. Clinicians need to be skilled in vaginal breech delivery despite this being a rare clinical situation. Simulation training provides a means by which uncommon clinical situations can be practised. This study aims to determine if the introduction of a simulation-based training course is associated with an improvement in the management of vaginal breech delivery and neonatal outcomes. Cases of term vaginal breech delivery five years prior to introduction of In Time training (2001-2005) and five years after In Time training (2007-2011) were identified in a tertiary obstetric hospital (King Edward Memorial Hospital, Perth). There were 136 women identified in the pre-training (2001-2005, n=56) and post-training (2007-2011, n=80) groups. Case note review was undertaken to gather information. Apgar scores of <7 at five minutes were higher in the post-training cohort (8.8% vs 0%, P=0.041). Arterial and venous pH readings were similar between cohorts, with a non-significant trend toward improvement in the post-training cohort. Special care nursery admissions and length of hospital stay were unchanged. The primary accoucheur was more likely to be a consultant (35.0% vs 16.4%) in the post-training cohort. Appropriate manoeuvres were more likely to be used in the post-training cohort (52.5% vs 44.6%). Obstetric In Time simulation training improved seniority of accoucheur and documented appropriate manoeuvres in the management of term vaginal breech delivery.

Development, Implementation, and Evaluation of a Faculty Development Workshop to Enhance Debriefing Skills Among Novice Facilitators.

IntroductionEffective debriefing during simulation-based training (SBT) is critical to promote learning outcomes. Despite debriefing’s central role in learning and various published debriefing methods and techniques, little is known about faculty development structure for debriefing training among novice facilitators. Continuing medical education courses often use simulation-based methods but provide minimal training in debriefing techniques to novice facilitators. We describe the development, implementation, and evaluation of a structured debriefing training workshop for novice facilitators.MethodsDesigned and conducted by simulation debriefing experts, a debriefing workshop was provided to novice facilitators serving as faculty during the simulation-based Sedation Provider Course (PC) at the 2018 Society of Pediatric Sedation conference. Emphasizing evidence-based key elements of effective debriefing, the workshop was divided into three components: 1) an introductory 30 minute didactic, 2) 75 minutes role modeling of simulated effective and ineffective debriefing 3) 120 minutes repetitive deliberate practice sessions with summative and formative feedback. Effective transfer of learned debriefing skills was assessed during facilitators’ PC debriefing using the Objective Structured Assessment of Debriefing (OSAD) tool, facilitators’ self-efficacy, and PC student learners’ evaluation of facilitator debriefings during the PC.ResultsSixteen facilitators participated in the 4-h workshop and the next day served as PC faculty. The median OSAD score was 31 (13-40) for all facilitators. OSAD components with lowest and highest performance were “Establishing Learning Environment” with a median score of 1 (1-5) and “Engagement of Learners,” with a median score of 4.75 (2.5-5). Facilitators' self- assessment in debriefing significantly improved on the 5-point Likert scale pre- and post-workshop, respectively. PC student learners’ evaluations revealed high degrees of satisfaction with debriefing quality.ConclusionsA proposed model integrating full-length debriefing and repetitive practice paired with summative and formative feedback provides a feasible and effective approach for debriefing training of novice facilitators for simulation-based educational courses.