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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Does a Written Tool to Guide Structured Debriefing Improve Discourse? Implications for Interprofessional Team

Ryan Thompson1, Sarah Sullivan2, Krystle Campbell3

  • 1Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Journal of Surgical Education
|August 11, 2018
PubMed
Summary
This summary is machine-generated.

A new debriefing tool significantly improved medical simulation education by increasing learner self-assessment and good judgment statements, while reducing directive feedback. This enhances skill acquisition and retention in trauma care teams.

Keywords:
Interpersonal and Communication SkillsPractice-Based Learning and ImprovementSystems-Based Practicedebriefingdiscourseinterprofessionalsimulation

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Area of Science:

  • Medical Simulation
  • Healthcare Education
  • Trauma Care Training

Background:

  • Effective debriefing is crucial for skill acquisition and retention in medical simulations.
  • Facilitator communication style, particularly the use of good judgment statements, impacts learning outcomes.
  • Current debriefing practices often rely heavily on directive feedback rather than learner self-reflection.

Purpose of the Study:

  • To evaluate the impact of a written debriefing tool on facilitator communication strategies during interprofessional trauma simulation debriefings.
  • To determine if the tool can shift the balance of discourse from directive feedback towards learner self-assessment and focused facilitation.
  • To assess changes in the ratio of judgmental, nonjudgmental, and good judgment statements used by facilitators.

Main Methods:

  • The study involved interprofessional trauma teams undergoing simulated events at the University of Wisconsin Joint Trauma Simulation Program.
  • Debriefings were video-recorded, transcribed, and analyzed for discourse categories: learner self-assessment, focused facilitation, and directive performance feedback.
  • Facilitator statements were coded as judgmental, nonjudgmental, or good judgment before and after the implementation of the TEAM Debrief Tool.
  • Pre- and post-implementation analyses compared discourse patterns and statement types to assess the tool's efficacy.

Main Results:

  • Learner self-assessment significantly increased (7.23% to 24.99%), while directive performance feedback significantly decreased (56.13% to 32.75%) after tool implementation.
  • The use of nonjudgmental statements decreased significantly (60.63% to 37.31%), with a significant increase in good judgment statements (38.77% to 59.82%).
  • Focused facilitation showed no significant change, but there was a slight increase in judgmental statements (0.60% to 2.87%).

Conclusions:

  • The TEAM Debrief Tool effectively shifted interprofessional trauma simulation debriefings towards higher-quality communication styles.
  • Implementation of the tool led to increased learner self-assessment and a greater use of good judgment statements by facilitators.
  • The findings demonstrate the utility of structured debriefing tools in improving the effectiveness of simulation-based medical education.