Engagement Across Professions: A Mixed Methods Study of Debriefing After Interprofessional Team Training

Area of Science:

• Medical Education
• Healthcare Simulation
• Interprofessional Learning

Background:

• Simulation offers an ideal platform for interprofessional (IP) team training.
• Effective debriefing is crucial for IP learning, but cultural and hierarchical factors can impede engagement.
• This study investigates factors influencing participation in IP simulation debriefing, including the experience of seemingly disengaged participants.

Purpose of the Study:

• To explore factors affecting learner engagement and participation in interprofessional (IP) simulation debriefing.
• To understand the experiences of participants who are silent but appear engaged during debriefing.

Main Methods:

• Mixed-methods approach using semistructured, profession-specific focus groups with participants from a pediatric IP simulation program.
• Thematic analysis of focus group transcripts.
• Comparison of self-rated engagement scores between "silent" and "verbal" participants using a t-test.

Main Results:

• Six key themes emerged influencing engagement: psychological safety, realism, distractors, stress, group dynamics, and facilitator actions, with profession-specific variations.
• Silent participants (n=18) reported feeling engaged, similar to verbal participants (n=18), despite differences in self-rated engagement scores (P=0.06).
• Physicians, nursing staff, pharmacists, and respiratory therapists shared diverse perspectives on debriefing effectiveness.

Conclusions:

• Learner engagement in debriefing is shaped by prebriefing and simulation elements, including psychological safety and facilitator conduct.
• Unique factors for IP simulation include realism's importance for non-physicians, protected training time, group composition, and co-facilitator strategies to mitigate physician bias.
• The study confirms that "silent" participants can be actively engaged, underscoring the need for inclusive debriefing practices in interprofessional training.