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Localizing and Tailoring the Debriefing Assessment for Simulation in Healthcare to Optimize Fit.

Jannet Lee-Jayaram1, Kyle Ishikawa2, Yu Jin Lee3

  • 1SimTiki Simulation Center, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, USA.

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|January 13, 2025
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Summary

Localized training and notations enhance the Debriefing Assessment for Simulation in Healthcare (DASH) tool, improving rater reliability and strengthening its validity for healthcare simulation debriefing. This ensures more consistent and context-specific assessment of simulation-based education.

Keywords:
assessment tooldebriefing assessmenthealthcare simulationrater trainingsimulation in medical education

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Area of Science:

  • Healthcare Simulation
  • Medical Education
  • Assessment Tools

Background:

  • Debriefing is crucial in healthcare simulation for reinforcing learning and improving patient care.
  • The Debriefing Assessment for Simulation in Healthcare (DASH) is a validated tool for evaluating debriefing quality.
  • Localized rater training for DASH has not been previously described.

Purpose of the Study:

  • To augment DASH anchors with localized notations.
  • To localize DASH rater training.
  • To assess the reliability and validity of the localized DASH tool.

Main Methods:

  • Conducted at SimTiki Simulation Center, involving simulation experts and research assistants.
  • Developed localized criteria by transcribing DASH behaviors and adding example notations.
  • Calibrated raters (ICC=0.884) and assessed interrater reliability (ICC=0.810) on 43 debriefings.

Main Results:

  • High interrater reliability (ICC=0.810) and consistency (ICC=0.825) were achieved with localized training and notations.
  • Convergent validity was supported by the correlation between DASH scores and observed best practices/factors.
  • Inconsistent use of 'not applicable' was noted in specific DASH behaviors (e.g., 2B).

Conclusions:

  • Localized rater training and notations significantly improve interrater reliability for the DASH tool.
  • Correlation with debriefing practices strengthens the validity evidence for the localized DASH.
  • DASH score interpretation requires contextualization within a shared, localized construct; cross-institutional comparisons may not reflect absolute quality.