Localized Debriefing Assessment for Simulation in Healthcare (DASH): Medical Student Engagement and Debriefing Assessment Validity

Debriefing is an essential component of simulation-based education; the Debriefing Assessment for Simulation in Healthcare (DASH) is a behaviorally-anchored rating scale that evaluates debriefing quality within 6 elements. DASH was validated with trained raters evaluating simulation debriefings; the student version (DASH-SV) has not been validated. Reported DASH-SV scores cluster on the high end of the 7-point rating scale and may not accurately reflect debriefing quality. We modified the DASH-SV with localized instructions to improve student understanding and rating accuracy. We hypothesize that the localized version (DASH-LSV) will lower score inflation, yielding more accurate scores and useful feedback for simulation faculty development. Medical students at the University of Hawaii were sorted into two balanced groups. After participating in routine faculty-facilitated simulation scenarios/debriefings, group DASH-SV completed the original student version and group DASH-LSV completed the localized version. These anonymous evaluations were completed via an online survey embedded in the standard post-course feedback form. Surveys included attention-check questions. Group DASH-LSV rated debriefers lower than group DASH-SV across a multitude of DASH behaviors. Group DASH-LSV answered the attention check question correctly at a higher rate (91%) compared to group DASH-SV (82%) (p = 0.005). Our localized DASH-SV resulted in lower rates of score inflation compared to the original for select debriefing behaviors. Students who used the localized DASH-SV exhibited greater attentiveness. The localized DASH-SV may be a more accurate tool for student assessment of debriefing quality and support meaningful faculty feedback to improve debriefing skill and education quality.

The online version contains supplementary material available at https://doi.org/10.1007/s40670-026-02825-1.