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An Evaluation of a New Debriefing Framework: REFLECT.
Lauren E Zinns1, Paul C Mullan2, Karen J OʼConnell3
1From the Department of Emergency Medicine, The Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY.
Pediatric Emergency Care
|April 19, 2017
Summary
The REFLECT framework improves postresuscitation debriefing (PRD) for pediatric emergency medicine fellows. This structured approach enhances team communication and feedback during critical care simulations.
Area of Science:
- Medical Education
- Emergency Medicine
- Team Performance
Background:
- Postresuscitation debriefing (PRD) is guideline-recommended but rarely implemented.
- Pediatric emergency medicine (PEM) fellows face barriers to PRD, including a lack of standardized training.
- Existing PRD practices often lack structure and evidence-based components.
Purpose of the Study:
- To develop and evaluate the feasibility of a structured PRD framework called REFLECT.
- REFLECT aims to improve PRD by incorporating key elements: Review, Encourage, Focus, Listen, Emphasize, Communicate, Transform.
- To assess the impact of a training workshop on the use of the REFLECT debriefing aid.
Main Methods:
- A single-center study involving 9 PEM fellows leading simulated resuscitations.
- Intervention included a 2-hour workshop on debriefing and the REFLECT framework.
- Pre- and post-intervention debriefings were videotaped and analyzed for REFLECT characteristics; fellow and team assessments were collected.
Main Results:
- All 9 PEM fellows completed the study.
- Significant improvements in REFLECT characteristics were observed based on fellow (63% to 83%) and team member (63% to 82%) perceptions.
- Debriefings remained brief, with no increase in duration post-intervention.
Conclusions:
- The REFLECT framework is a feasible tool for enhancing postresuscitation debriefing.
- REFLECT effectively integrates evidence-based characteristics into PRD.
- This structured approach shows promise for improving PRD in pediatric emergency medicine.